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COPYRIGHT DEPOSIT 



EVOLUTIONARY PRACTICE 

OF MEDICINE AND 

SURGERY. 



CAUSES AND DIAGNOSES OF 
CHRONIC DISEASES 

ESPECIALLY OF 

PROSTATE, KIDNEY, HEART, 

STOMACH, LUNGS, 

NEUROSES, 

ETC. 



BY 

GEORGE WHITFIELD OVERALL, M.D. 

AUTHOR OF "NON-SURGICAL TREATMENT OF DISEASES OF THE 
PROSTATE AND ADNEXA," ETC. 



CHICAGO 

ROWE PUBLISHING CO. 

1914 



.03 



COPYRIGHTED 

ROWE PUBLISHING CO. 

CHICAGO 

1914 



JAN 26 1914 



©CU369294 

* v / 



TABLE OF CONTENTS 

PAGE 

Preface 7 

Introductory 25 

Chapter I. 

Anatomy and Histology of Nervous Systems. Causes and 
Diagnoses of Diseases 51 

Chapter II. 

Anatomy and Functions of Organs Involved 81 

Chapter III. 

Acute Prostatitis 87 

Chapter IV. 

Subacute and Chronic Prostatitis, with Granulated Urethritis, - 

Vegetative Growths, Proud Flesh, Cystitis 90 

Chapter V. 

Congested Glandular Enlargement of the Prostate, Vesiculitis, 
Complications of Cystitis, Vegetable Growths, Proud Flesh, 

Polypi, etc 164 

Chapter VI. 

Senile Hypertrophy and Its Complications with Cystitis, 

Vesiculitis, the Rectum, etc 211 

Chapter VII. 

Sigmoiditis, Pyrosaks, Overticulae 245 

Chapter VIII. 

Tuberculous, Syphilitic Prostatitis, Cystitis, Vesiculitis 268 

Chapter IX. 

Neuroses of Prostate and Adnexa 276 

Chapter X. 

Brief outline of Anatomy, Histology and Pathologic Changes 
as influenced by perverted conditions of the Prostate Gland, 
and Sequelae to various lesions detailed in this work. ...... 301 

Chapter XI. 

Congested Inflammatory Conditions, arising as Sequelae to 

Lesions of the Prostate, Bladder, etc 313 

Chapter XIX. 

Miscellaneous Cases , 317 

iii : 



ILLUSTRATIONS 



PAGE 

I. Cell formation, fecundation and propagation of plants; 

Antheridium (male) 32 

II. Cell formation, fecundation and propagation of plants; 

Archegonia (female) 32 

III. Fibrous cellular structure of wood, and channels through 

which nutritive matter and air pass from the leaves 
to the roots, to be used for the development of the 
plant or tree 34 

IV. Special sympathetic ganglia of pelvic organs 53 

V. The abdominal brain and its connections 54 

VI. Abdominal and thoracic viscera 55 

VII. The perineal nerves, indexes to special lesions 56 

VIII. Construction of cerebral and ganglionic nerve cells .... 57 

IX. Terminal sciatic nerve cells 60 

X. Central nerve impulses arising from special lesions 61 

XI. The prostate, its sympathetic and central nerve con- 
nections, and genito-spinal center 64 

XII. The prostate gland and other important structures, also 

ureters with their openings into the bladder 82 

XIII. First stage of an inflamed Condition of the prostatic 

urethra 91 

XIV. Diagrammatic illustration of extension of inflammation 

in the prostatic urethra, development of proud flesh, 

vegetative growths, and occlusion of urethra 93 

XV. Diagrammatic illustration of the use of the author's 

cystoscope, in the locating of special clinical ulcers. . 115 
XVI. Diagrammatic use of the author's cystoscope in viewing 

the condition of the prostate and neck of bladder. ... 117 
XVII. Application of medicine through the author's especially 
devised instruments to ulcers in the prostatic urethra 

and neck of bladder 119 

XVIII. Diagrammatic illustration of the inflammation of the 

prostate, bladder, and its extension to the rectum . . . 165 
XIX. Photo engraving of a mass of concretions dissolved and 

passed as described in text 182 

XX. True Senile Hypertrophy of the Prostate 212 

iv 



XXI. False passage made by the use of a sound, through the 
third middle pathologic lobe, resulting from true 

hypertrophy i 216 

XXII. Enlargement of middle lobe, with a concretion at its 
base; also thickened, indurated, and corrugated walls 
of bladder 220 

XXIII. Diagrammatic illustration of prostatectomy, showing 

the rugged sinus from which the gland has been 
removed 231 

XXIV. Diagrammatic illustration of the sphincter urinae mus- 

cles, internal and external; also the prostate, showing 
removal of muscles intended to retain the urine, 
which removal causes inability to retain the same . . . 233 
XXV. Diagrammatic illustration of ulceration of the sigmoid 
and stricture resulting therefrom. Shows also the 

parts to be removed by the operation (OP) 246 

XXVI. Diagrammatic illustration of rectum, showing valves 

and ulceration 248 

XXVII. Diagrammatic illustration of the operation, showing the 
usual sequel of adhesions and occlusions of rectum 

necessitating the formation of a false anus 249 

XXVIII. Diagrammatic illustration of the location of a pyrosak . 252 
XXIX. Diagrammatic illustration of the position of kidneys, 
and of two points of special diagnostic significance 

in cervical and lumbar regions 296 

XXX. Indurated thickening and contraction of bladder walls 

due to true hypertrophy of the prostate 302 

XXXI. Thickened, indurated, sacculated bladder walls, due 

to same 304 

XXXII. Inflamed and indurated thickening of walls of bladder; 
which condition extending by continuity through the 
ureters to the pelvis of the kidney results in pyelitis, 
degeneration, and extension to the true parenchyma 
of the kidney 306 

XXXIII. Kidney. Ureter (U), pelvis (P), and true parenchyma; 

(3, 4, 5, 6, etc.) showing extension of inflammation 
from the bladder through the ureters and involving 
different parts of the kidney 308 

XXXIV. Engorgement of abdominal veins, caused by prostatitis, 

proctitis, vesiculitis, disturbing the organs in the 

whole of the abdominal and thoracic cavities 312 

XXXV. Passage of embolus (B) through large veins till arrested 

by a small vein (A) 316 

V 



PREFACE. 



"Sound and sufficient reason falls after all, to the share of but few 
men, and those few men exert their influence in silence. ' ' — Goethe. 

For almost one-third of a century the writer has con- 
centrated all his energies and efforts towards determin- 
ing the cause and cure of chronic diseases. While each 
successive year has been signalized by noteworthy im- 
provements, yet during the last decade — and more espe- 
cially during the last three years — he has made greater 
strides towards success than in any like period of his 
long, active, professional career. 

Although the writer has not yet fully reached the 
goal towards which he has so long and so tenaciously 
struggled — the ideal, perfection — yet he feels that the 
object of his long-haunting dream has, at last, been 
attained; in that he has succeeded in ascertaining the 
causes, diagnoses and cure, of from eighty to ninety-five 
per cent of all those chronic diseases that have hitherto 
been considered incurable ; and he has also discovered 
methods of removing the chief etiologic factors of almost 
all acute, infectious and contagious diseases. 

It is now six years since the last edition (the third) 
of my work was issued from the press. Since that time 
there have been many noteworthy improvements and 
discoveries made. Of special interest are the discoveries 
of various causes of disease, which are of great assistance 
in the diagnoses, not only of the troubles traceable to 
the kidneys and other genito-urinary organs, but also of 
obscure heart, nerve, and circulatory complications, 

7 



.8. 

characterized by an excess of alkali or acid in the urine 
which gives rise to many other organic diseases as well 
as rendering many vital organs inert or prematurely 
old by failure to eliminate the excess of such constitu- 
ents, and by rendering the tissues brittle and so satu- 
rated with them as to prevent normal transudations of 
nutritious matter to the bodily organs, and the expelling 
of worn out or deleterious matter from the system. 
There are so many of these points which are of vital 
interest to the general practitioner as well as to the 
specialist that I hesitate to curtail free discussion con- 
cerning them, as I am almost compelled to do by limita- 
tions of space. 

At an early stage of the author's professional career, 
while engaged in giving clinical lectures upon nervous 
diseases, he became convinced that the large majority of 
such troubles were traceable, either directly or indirectly, 
to lesions of organs, located, in some instances, far remote 
from the apparent seat of the trouble. In fact, it is 
rare to find lesion of the central nervous system "a 
priori." 

The greatest difficulty experienced by the author at 
this era, however, lay in the fact that at that time there 
existed no trustworthy books or precedents by which 
he could guide his course, and he was necessarily com- 
pelled to establish his own premises, deductions and 
conclusions. 

While the circulation of the three former editions of 
my book (over 18,000 copies) has familiarized a great 
many of the profession with my main line of work for 
the past quarter of a century or more, in the treatment 
of prostatic, kidney and bladder troubles, and while 
there have been .many physicians who have expressed 
themselves as having derived much benefit therefrom 



(although they admitted they had often previously been 
groping in the dark), there have been others who have 
never procured satisfactory results. In speaking with 
some of these physicians, when demonstrating certain 
clinical points, I learned that the chief reasons for their 
failure arose mainly from the lack of experience in the 
practical uses of instruments, and lack of knowledge 
when to use certain remedies in acute stages of the 
trouble, and in sub-acute or chronic conditions. Each 
of these conditions requires an entirely separate and 
distinct mode of treatment as well as remedy for its 
relief. Great harm results from the injudicious advice 
of self-styled professors, teachers, and special mail 
courses on the uses of unsuitable remedies, including 
electricity, etc. I have been compelled to discharge two 
of my assistants for following some of their advice, even 
in my own office, and effecting harm before detection. 
They wanted to cure quick. Some of the worst cases of 
stricture, inflamed prostates, and even prostatic abscesses 
have come from treatment by the professors themselves. 
Almost as great a source of evil are the crude instru- 
ments that have flooded the country, which do more 
harm than good. In a clinical demonstration, one of 
the physicians present stated that he could now easily 
understand why he had failed to locate a special lesion, 
as the "landmark" was entirely different from what he 
had expected to find. Another could not determine, in 
many instances, when the instrument passed through 
the prostatic urethra. Others were unable to tell whether 
the patient had true hypertrophy or parenchymatous 
enlargement. The greatest difficulties encountered usu- 
ally were to determine to what the condition was due, 
and whether it was acute, sub-acute or chronic. In fact, 
only a very small proportion of physicians can diagnose 



10 

these cases accurately, without having had considerable 
clinical experience. Many times, when points of differ- 
ential diagnoses were clearly demonstrated by means of 
the technique of my instruments, the physicians, as they 
themselves expressed it, had been "at sea" before. They 
were unable to tell how or when to make the "curve" 
entering the prostatic urethra or bladder. Some would 
bend the instrument too soon, before reaching the place 
where the lesion was located; others would pass it 
entirely within the bladder beyond the ulcer or sore 
and apply the medicament to a wrong locality; while 
others, who curved too soon, would apply the remedies 
to healthy tissue within the urethral canal, before reach- 
ing the lesions. One would be surprised to learn how 
common such errors are among so-called "prominent" 
G-. U. professors. There are but few physicians that 
ever learn to pass an instrument over the triangular liga- 
ment without using force, which gives rise to extreme 
pain and often more than counteracts the benefits result- 
ing from the treatment. On the other hand, there are 
others who have succeeded beyond my most sanguine 
expectation. The most serious as well as the most fre- 
quent of all troubles arise as a result of too much treat- 
ment, and especially from the injudicious use of elec- 
tricity. 

There are eight special lesions, the locations, causes, 
and treatment of which have been definitely ascertained, 
and the ganglia controlling the organs subject to these 
lesions are also known. There is absolutely no case that 
may be considered free either from one of these lesions, 
or one of the complications that may arise therefrom. 
From these eight lesions not less than ninety per cent, of 
all chronic diseases arise, and they are also indirectly the 
precursors of many acute infections or contagious dis- 



11 

eases. These facts have been arrived at by numerous 
clinical results, and they can be demonstrated in nine- 
tenths of the chronic diseases with which men, women 
and children suffer. 

The writer, having taken his medical degree at the 
Jefferson Medical College of Philadelphia (America's 
greatest Medical Institution) under Professors Gross, 
Pancoast, Meiggs, DaCosta, etc., the Nestors of medical 
instructors, he naturally expected, from such a source, a 
definite science ; and from long-tried and highly-extolled 
remedies he anticipated definite results. 

Full of enthusiasm, and sanguine of expectation when 
beginning the practice of medicine, one can little con- 
ceive of my utter despair and disappointment when I 
found I was unable to cure, at first, many of the most 
common chronic diseases with medicines. 

It was then, however, that the writer was elected to 
the chairs of Physiology and Clinical Neuroses. One 
never so thoroughly masters a subject as when he at- 
tempts teaching it to others; and the exacting, arduous 
labor requisite to the preparing and delivering of three 
and often four lectures a week on the functions of organs 
enabled him to so differentiate between the functions of 
organs when in a normal condition, and when influenced 
by functional disturbances, pathologic lesions, or disease, 
that it gave him a new insight into the only real basic 
principles of the scientific practice of medicine. 

During all these years, the writer has proceeded in 
his unostentatious way, demonstrating each step by 
chemic, physiologic and clinical proofs; yet at intervals 
contributing some of the results of his research to medi- 
cal journalism. Among the first of these contributions 
was one to the Mississippi Valley Medical Journal, in 
March, 1883 ; in August, 1887, a second article appeared. 



12 

In April, 1896, he again contributed to the Medical 
Mirror; and to the Journal of the American Medical 
Association, January 21, 1889. 

In this volume I have endeavored to deal only with 
cold, stubborn facts; facts not based upon theory or 
guess work, not upon laboratory investigation, or a few 
isolated clinical observations, but with facts founded upon 
premises, deductions and conclusions strictly in accord- 
ance with physiological laws and toxic conditions as in- 
fluenced by morbific states, and proved by hundreds of 
authentic clincial residts. 

All intelligent laymen, as well as physicians, know 
that the most crucial epoch of the lives of both men 
and women is at the age of puberty, and the few years 
subsequent thereto; but it is not generally known that 
the next more serious period of the lives of both is at 
the menopause, or change of life. This period occurs 
both in men and women at, or about the age of forty to 
fifty. While it is generally known to physicians, that 
women have serious ailments about this period, yet it is 
not so well known that men, too, suffer with analogous 
troubles. It is also true that early marriage is con- 
ducive to good health and longevity. Although these 
facts are universally conceded, there are few (if any) 
of our most logical physicians that know or have ever 
thought of the physiologic and pathologic reasons there- 
for. 

It doubtless seems incredible to one not having had 
practical experience in this line, to learn that scarcely 
one in five men reach manhood free from lesion or 
abrasion of the prostate, kidneys, heart, or other vital 
organs. The writer, with many others, believes that 
abraded surf aces- are accountable for the contraction of 
many contagious and infectious diseases. In fact, many 



13 

believe, with him, that morbific germs can infect only 
through mucous membranes or an abraded surface. 

One of the best and latest books on bacteriology states : 
" Bacteria are so minute and so ubiquitous that scarcely 
anything is normally free from them, and they are so 
hardy that it is exceedingly difficult to destroy them, 
without at the same time destroying the substances 
which it is desired to sterilize. They are not normally 
present in the living tissues of plants or animals, which 
are sealed against their entrance by skin or epithelium; 
but after these are cut or broken (as in a wound), bac- 
teria speedily invade the tissues. " 

During the eight years that I was Professor of Physi- 
ology and Clinical Neuroses, I had occasion to treat many 
nervous diseases; and, while I at times gave temporary 
relief, relapses continued from day to day, until my 
patience was completely exhausted. With an abundance 
of clinical material, the neurotic diseases were often 
benefited by treatment of the central and peripheral 
nerves; and I labored earnestly to make symptoms, con- 
ditions, and results of treatment bend to my precon- 
ceived ideas and to the fascinating theoretical teachings 
in vogue at that time, and with which the books upon 
nervous diseases were teeming; but extensive clinical 
observation and practical experience would prevail ; and 
I was finally driven, though reluctantly, to yield to the 
oft proven and inevitable fact, that in almost every 
instance (with the exception of traumatism and syph- 
ilis), nervous diseases were traceable, either directly or 
indirectly, to lesion of some other organ as the prime 
cause of such ailments in both men and women; and 
when these lesions were relieved the nerves usually 
took care of themselves, or very little treatment was 
required thereafter to restore them to their normal con- 



14 

dition. Not only was this made manifest in func- 
tional neuroses, but central organic lesions often super- 
vened as a result of continuous! pounding upon the 
cerebro-spinal centers, by reflex irritation of peripheral 
nerve terminals. 

I was therefore compelled to change my practice, from 
that of specialist in nervous diseases, to that of the 
treatment of genito-urinary and other chronic diseases. 

Not having had any experience in this line of work, 
up to that time, I most naturally turned to my college 
instructions and works on the subject as a guide. The 
methods in use at that time (and there has been little 
or no improvement since) were inadequate and unre- 
liable. After having tried them with very unfavorable 
results, I turned my attention to the discovery of more 
rational means of treatment. 

While my present methods may seem simple, many 
complicated and perplexing problems had to be dealt 
with and overcome before they reached their present 
state of perfection. At times I would have happy hits 
to be followed by utter failures. 

I had been importuned for two decades by many of 
my patients (mostly physicians, who had been treated 
successfully by me), to write a book on the subject, 
from fear the results of my investigations and discov- 
eries would be lost to the world. But it was many years 
before I felt that the clinical results warranted my incor- 
porating them in book form — until I felt convinced that 
my efforts for perfection had been successful. 

In writing my book, I made no effort at display, and 
I was determined that it should not be bulky. It 
required more time to condense than to write it. Its 
contents are based wholly upon clinical facts ; and I am 
extremely gratified that many of my readers have been 



15 

so appreciative, as to have procured a copy of each, of 
the three editions of my former book. 

Dr. Sour, an eminent physician of Minnesota, aptly 
voices the sentiments of many other readers, when he 
wrote the following to the Medical Summary of 1908, 
page 24, as follows : \ ' We have learned some very excel- 
lent things from Dr. Overall's book on the treatment 
of the prostate gland, and it certainly should be read 
by every thoughtful, up-to-date practitioner, for he will 
have conditions of the prostate that can only be treated 
in a sensible way by having a thorough knowledge of 
this book. Dr. Overall has worked out a system of his 
own that is original, practical, and gives results that no 
other treatment or method can. He has carved a way 
for himself, and we must all say he is absolutely right. 

In all gonorrheal practice, cases will come up with 
the prostate gland involved, and the trouble with so many 
of us is, that we grope in the dark — treat the symptoms 
found at the urethra, subject it to all sorts of mal- 
practice and never for once think or try to find out the 
cause of the whole trouble. We simply go about it in a 
blind way. We were not so much to blame, however, 
because we had no real up-to-date book on this subject, 
and operating on the gland was not satisfactory. But 
since Dr. Overall has drawn the curtain aside and shown 
us facts that he proves every day, we have no excuse, 
for we can now know ourselves how to relieve these 
cases." 

For many years the writer has been so busy studying 
the laws of Nature, and the normal or physiologic states, 
' as well as the pathologic conditions brought about by 
different lesions and conditions of the surrounding media, 
that he has not had time to study the various theories 
advanced, and the chemic and laboratory researches of 



16 

others, as he would have liked to have done. He has 
only glanced at them from time to time, noting the 
various theoretic deductions, and has been surprised at 
the channels followed for so many years without results. 
It is strange that the medical profession has seemingly 
gone wild upon serum therapy, without reference to 
cause or effect, and without demonstrating its utility or 
practicability ; it has rushed from one theory to another, 
year after year. Some thirty years ago Dr. Bergmann, 
a physician in London, startled the world by his discov- 
ery of a cure for consumption, by means of sulphuretted 
hydrogen rectal injection. The country went frenzied 
about it, and in the United States, every one was making 
apparatus for its production and use. The bubble soon 
exploded; and it was observed that the scheme origi- 
nated from the fact that relief was obtained by the 
local effect of this gas upon the rectal-mucosa. Brown- 
Sequard was the next in line with his goat lymph, which 
induced abscess after abscess; blood-poison following so 
often, that physicians who had used it were glad to seek 
cover to escape malpractice suits. Murphy, of this 
country, followed with his wild theory of injecting iodine 
into lung tissue. Great sensation was aroused in the 
American Medical Association, until this bubble ex- 
ploded in like manner, and he, too, sank into gentle 
oblivion. Dr. Keyes of Chicago followed in their path 
with injections of oils, pretending to cure consumption or 
tuberculosis. Of recent date is the Friedmann and 
Duckett mendacity, with many others along the same 
lines. ' ' 606, " or " Salvarsan ' ' — the ' ' arsenic treatment ' ' 
as it is termed (nine grains of arsenious-acid injected 
into the vein at one time), startled the world as a cure 
for syphilis some few years ago. It is unnecessary to 
state the number^of deaths which followed, nor is it pos- 



17 

sible to compute how many have been carried from hos- 
pitals at night and secretly buried. An interne of a 
prominent hospital, who noted its administration for a 
year, told the writer that often three and four patients 
were killed daily, and the number of blind and maimed 
by its use are too numerous to count. 

It seems strange that these various tests could not have 
been made and discarded at home or in hospitals, before 
being launched into publicity, and resulting fatally in 
so many cases. As before stated, the writer has substan- 
tiated each step of his own method thoroughly, and that 
for more than a quarter of a century. They have been 
demonstrated by physiologic laws to be the true prem- 
ises, deductions and conclusions, and have been proven 
by many thousands of clinical cases. 

ERRONEOUS DIAGNOSES 

The number of mistakes made in diagnosis is really 
appalling to anyone who has closely observed and re- 
corded such. In truth, I do not believe there are on 
the average, two per cent of correct diagnoses made by 
physicians in general. This fact has become so apparent 
that it is now usual for physicians to send their patients 
to surgeons to be operated upon in order to clear up the 
diagnoses. Especially is this true with abdominal 
troubles. As Dr. E. L. Keyes truthfully remarks, "there 
have as many instruments been invented and made for 
removing the prostate as would sink a ship. " 

I do not think it would be exaggeration to state, that 
enough healthy ovaries and healthy appendices have been 
removed to sink a ship. Of the many chronic cases 
that have come to the writer for treatment, giving the 
diagnoses of different physicians, I do not believe that 
one-half of one per cent of them have been correct. 



18 

These included many cases of prostatitis, cystitis, vesi- 
culitis, pyelitis, and heart, nervous and abdominal com- 
plications; and especially cases where the urine was 
loaded with mucus and pus. Most of these latter cases 
were classed as * ' Bright 's Disease. ' ' The term ' ' Bright 's 
Disease" as it is generally understood by both the pro- 
fession and by laymen is quite an elastic one, and in- 
cludes practically all those diseases of the bladder, pros- 
tate, seminal vesicles, pelvis of the kidney and other 
conditions that give rise to a muco-purulent deposit in 
the urine. There were many cases, however, of pyelitis, 
where the pelvis of the kidney had been involved for 
many years, without giving rise to interstitial nephritis, 
or true parenchymatous inflammation of the kidney. 

It is somewhat humiliating — or at least, it grates upon 
one's vanity — to have to acknowledge having made in- 
correct diagnoses; yet this should not be, as we profit 
most by our errors, and one should not make the same 
mistake a second time. 

A distinguished diagnostician of New York City was 
bold enough to recently publish an article on "A Study 
of Mistaken Diagnoses," giving statistics of one thou- 
sand (1,000) cases examined and treated before death 
and in each case followed by an autopsy ; and comparing 
the first diagnoses with those found after death. In this 
report, published in the J. A. M. A., the diagnoses, in- 
cluding the most common and simple of diseases, as the 
writer states, " where even a tyro in medicine could 
record at a glance, ' 9 only an average of 50 per cent were 
correct. In some of the obscure diseases like nephritis, 
pericarditis, myocarditis, etc., there were only about 16 
per cent of the diagnoses correct. That is, there was 
less than one correct diagnosis, to six erroneous. Now, 
if a man of his recognized superiority as a diagnostician. 



19 

and with his special clinical opportunities, makes that 
many errors, what can be expected from the ordinary 
practitioner, especially in regard to kidney, heart 
and obscure nervous diseases. Even in the 16 per 
cent of correct diagnoses in heart, liver and kidney 
diseases, the causes of these different diseases were not 
given. 

The following are a few of twenty quotations that 
were compiled by a "professor" in a Chicago medical 
college, and published in the June, 1910, edition of the 
Medical Brief, in answer to : "Is the Practice of Medi- 
cine a Science ? ' ' 

"The present practice of medicine is a reproach to 
the name of science, while its professors give evidence 
of an almost total want of true knowledge of the nature 
of proper treatment of diseases. Nine times out of ten 
our miscalled remedies are absolutely injurious to our 
patients, suffering under diseases of whose real charac- 
ter and cause we are most culpably ignorant." — 
Jameson, M. D. 

"The reason medicine has advanced so slowly is be- 
cause physicians have studied the writings of their pre- 
decessors instead of nature. ' ' 

"The older physicians grow, the more skeptical they 
become of the virtue of medicines and the more they are 
disposed to trust to the power of nature." — Alexander 
H. Stevens. 

"The science of medicine is a hopeless assemblage of 
inaccurate ideas, of deceptive remedies, and of formulae 
as fantastically conceived as they are tediously arranged, 
an incoherent assemblage of incoherent opinions." — 
Bichat, M. D. 

1 ' I tell you, what I say is the truth of God. I am an 
old physician, I am an old professor, but I want to tell 



20 

the truth. "We are guessing in the dark, and there is 
no such thing as medical science. ' ' — Douglas MacClagan, 
M. D. 

"Medicine is a great humbug. It is nothing like sci- 
ence. Doctors are mere empirics when they are not char- 
latans. We are as ignorant as man can be. I tell you 
frankly I know nothing of medicine. I repeat to you; 
there is no such thing as medical science." — Magendie. 

"I firmly believe that if the whole materia medica 
could be sunk to the bottom of the sea it would be all the 
better for mankind and all the worse for the fishes." — 
Oliver Wendell Holmes. 

Similar opinions could be quoted ad nauseam. 

Numerous letters have recently come to the author of 
this book asking why he did not belong to the American 
Medical Association. In reply : there is no physician in 
the City of Chicago who practises medicine in a more 
ethical way than the present writer ; but for many years 
he has been aware of the fact that the A. M. A. had 
degenerated into one of the most flagrant political ma- 
chines in the country. This opinion is corroborated by 
statements by Dr. Lydston, who has been for many years 
past a member of the A. M. A., in the Pacific Medical 
Journals, as well as in numerous pamphlets. The A. M. 
A. is "run" by its "peerless leader" (who procured his 
medical degree practically by proxy) for his own per- 
sonal aggrandisement, and that of some twelve or fif- 
teen other "leaders!" 

The law courts have recently sustained the allegations 
of Dr. Lydston against the A. M. A., especially in regard 
to its irregularities. 

The writer has been frequently solicited to join the 
association, but he has always declined; stating as a 
reason that he cannot understand how any self-respect- 



21 

ing physician can conscientiously remain a member of 
the association or its subsidiary state societies, so long 
as it is conducted in its present manner. It was stated 
that the object in procuring additional membership was 
mainly to get the association out of control of this clique. 

It is a lamentable fact that the surgeons chiefly control 
the organ of the A. M. A. This journal let an article 
slip into its columns by Dr. Bayard Holmes, who therein 
states : ' ' Modern aggressive surgery has made the hos- 
pital into a hotel for the temporary care of the vivisected. 
All that the surgeon cares for is a room for his patient 
to occupy during the three or four weeks he is recover- 
ing from the incisions. He may then go home and get 
well, or lead a life of invalidism, as it happens." In 
answer to a rebuke for daring to publish such an 
exposure, the editor replied "that the statements 
would not have been published had their import been 
realized. ' ' 

Dr. James Rigby of Preston, England, writes on the 
same subject, as follows: "There has arisen a class of 
surgeons, callous and indifferent to the true welfare of 
their patients, whom they look upon merely in the light 
of subjects to be experimented and operated upon. These 
surgeons, regardless of age or any other deterring con- 
sideration, have no hesitation in embittering the last 
moments of their patients, by operations, often under 
the specious plea of giving them a chance ; thus, what 
should be a peaceful deathbed scene becomes converted 
into a seance of operating surgeons and nurses, to whom 
the suffering patient is merely "an interesting case." 
Dr. Rigby was severely censured, though the facts were 
not denied, by the British Medical Journal, which stands 
in the same relation in Europe that the J. A. M. A. does 
in this country. 



22 

Dr. Waite, in an article in the Medical Record, one 
of our most prominent independent medical journals, on 
' ' The Surgical Situation, ' ' writes : ' ' The time has come 
when a reform is bound to be inaugurated. If it does 
not come from within it will come from without. If we 
do not reform ourselves we will be reformed, nolens 
volens. The laity are not all fools, and the surgical situ- 
ation is no longer a professional secret. Putting aside all 
questions of ethics, of our duty as a profession toward 
a confiding laity, the law of self-preservation forces us 
to take up this question in earnest. " 

The predictions of Dr. "Waite are evidently coming true, 
inasmuch as some of our Western states are legislating 
against this injudicious and indiscriminate butchery by 
surgeons. A provision has been agitated, if. not passed, 
in the legislature of one of the "Western states, where if 
a surgeon is caught removing a healthy appendix he is 
to be prosecuted criminally and made to serve a term in 
confinement. 

The key-note upon this subject was sounded by Dr. A. 
Jacobi of New York. In an address by him in the Inter- 
national Congress at Rome, April 4, 1894, on "Non- 
Nocere" (do no harm) he said: "The relative impunity 
of operative interference accomplished by modern asepsis 
and untisepsis, has developed an undue tendency to, and 
rashness in, handling the knife. The hands take too 
frequently the place of brains. Who does not know that 
the alleged safety in operating tempts some of our skilled 
operators and the credulous public into useless, or even 
contraindicated procedure V 

In the dedicatory address delivered in the Senn Hall, 
December 17, 1902, by Sir William Hingston, Professor 
of Clinical Surgery at Laval University, Montreal, he 
gave warning that the surgeon's knife may be used too 



23 

frequently. In part he said : ' ' The immunity with which 
the most formidable operations are performed has given 
confidence — might I not say recklessness, possibly ? — 
which renders the staying hand of the physician of 
priceless value. " 

Damage once done by the knife is irreparable. "Rather 
bear the ills we have than fly to others that we know 
not of. " 

The Author does not wish it understood that he con- 
demns the use of the knife under all circumstances. On 
the contrary, he maintains that operations in some cases 
are absolutely essential. He advocates that it is the in- 
violable duty of every physician, in whom the credulous 
patient confides, to exhaust every other means for relief 
before advising him to go under the knife. 



INTRODUCTORY 

All substances, whether organic or inorganic, and 
whether atomic, molecular or large planetary bodies, 
contain an imponderable fluid, known as electric poten- 
tial, that exists either in a positive or negative state. 
Bodies sufficiently charged with this fluid, when brought 
into close proximity to one another, will, if they contain 
like forms — both positive or both negative — repel each 
other ; if, however, they hold unlike forms — one positive 
and the other negative — they will attract one another. 
Hence the universal law of attraction and repulsion, as 
applies to electro-magnetism, that likes repel and unlikes 
attract. The molecules of all bodies have these forces 
so evenly counterbalanced, by virtue of the attractive 
and repulsive power of each individual molecule, as to 
hold these fluids in a state of perfect quietude, and it is 
only when this equilibrium is disturbed that the electric 
current is manifested. 

If this equilibrium is disturbed by friction it produces 
what is known as static, Franklinic, or frictional elec^ 
tricity; when disturbed by chemic action, or the revolv- 
ing of a helix in the field of a magnet, it produces the 
galvanic or dynamic current. The faradic, high fre- 
quency, and other currents are produced by modification 
of these. 

All substances do not contain the electrical potential 
in the same proportion; in fact, they differ very much 
in their degree of potency ; so that one of a higher poten* 
tial is always positive to one of a lower that is negative. 
Hence, a body may be positive to another of lower poten- 

25 



26 

tial that it is negative, yet negative to a third of higher 
potential that is positive. For example: zinc is positive 
when coupled with copper, but it is negative when 
coupled with sodium; while copper, though negative 
when coupled with zinc, is, when coupled with carbon, 
positive. The electro-motor force of each atom or mole- 
cule is thus merely relative to that of other atoms or 
molecules. 

The same applies to larger bodies, as the earth, moon, 
sun and other planets, and it is by means of this relative 
inherent force, in each, that the attractive and repulsive 
forces of one acting upon the others are so equally 
counterbalanced, that it is one of the main agencies that 
serve to maintain all these different bodies in their posi- 
tions. 

The electro-motor force exerted upon the earth by the 
moon, sun and various other planets, often becomes dis- 
turbed; and the disturbances are manifested in various 
ways. A disturbance not only influences the conditions 
of the weather, tides, etc., but it also influences, under 
certain conditions, the electro-motor force as it exists 
in our bodies. By way of illustration — one maintains 
his health when he is subjected to normal conditions 
of the atmosphere or media around his body (through 
which the passage of a current from the atmosphere 
above to the earth below is constantly taking place) , when 
the air or conducting medium is comparatively dry 
and a poor conductor; but when the air or medium 
becomes damp, and consequently a better conductor of 
electricity than is dry air, it so disturbs or depletes the 
body of its normal amount, that it brings about de- 
pression, languor, etc., and the subject will complain 
of "rheumatic pains. " This is evidently due to the 
fact that the atmosphere or media surrounding a per- 



27 

son when it is moist favors the conducting or depleting 
of the normal amount of electricity from his body, by 
means of induction, convection or conduction; and the 
body of one in such media may become so depleted, as to 
bring about the above described condition. This indubi- 
table fact has doubtless been observed by many laymen as 
well as by physicians, especially in old men, where certain 
conditions so lower their electro-motor force or vitality 
as to be manifested by aches and pains. Almost any one 
can recall incidents of old men saying that "there is 
going to be a storm, or it is going to rain, ' ' as their corns 
hurt them, or as their "rheumatic pains" indicate, but 
few know the real cause. 

All planets, including the sun, earth and moon, vary 
in their electro-magnetic properties. This variation is 
due largely to their internal composition; some contain- 
ing more or less matter possessing magnetic properties, 
like " lode-stone ' ' or similar material, which is capable of 
being rendered magnetic by electric accumulation and 
thus rendered capable of giving off electric or magnetic 
power. Owing to the variation in the internal construc- 
tion of the different planetary bodies, they may also vary 
with reference to their electro-magnetic properties ; owing 
to which, a small body may exert a greater electro-mag- 
netic potential than a larger body. The different planets 
are therefore reciprocally attractive or repellent one to 
another, this being conditioned by the arrangement of 
their poles. "When the positive pole of one planet is in 
close proximity to the negative pole of another planet, 
they are mutually attracted ; whereas if their like poles, 
both positive or both negative, be in close proximity they 
will repel each other. Therefore, the action of the differ- 
ent poles of these planets upon each other, one attracting 
or pulling, the other repelling or pushing, causes thereby 



28 

motion, rotation or movement in different directions; 
and also maintains these bodies, suspended as it were, 
in vacuum or ethereal space, or may be surrounded by air 
or other gases ; which may favor this constant motion by 
overcoming, as much as possible, the resistance that might 
be offered by the surrounding media. 

This may be illustrated by a storage battery; except 
that the storage battery is only capable of receiving and 
maintaining the electric current and is minus the mag- 
netic properties possessed by the earth or other planets ; 
owing to the fact that the storage battery does not have 
similar ingredients in the way of " lode-stone ' 9 to main- 
tain and give of magnetic properties. Dynamos and 
electric motors are so constructed as to be rotated by 
means somewhat similar to those which cause the revolu- 
tion of the planets. 

The consummation of such colossal achievements could 
not have been effected by any other than by a supreme 
being or Deity. No human being could possibly have 
conceived of, or perfected, such wonderful structures, 
or their movements. 

Hydrostatic and atmospheric pressure as exerted by 
these forces and arising from the revolving of the earth, 
sun and planets, causing water to seek its level, and 
overcoming the cohesive power of its molecules, neces- 
sarily gives rise to various tides, and to other conditions, 
that so affect the atmosphere, or surrounding media of 
human beings or animals, as to cause various manifesta- 
tions of functional disturbances and aggravate patho- 
logic conditions in living creatures. 

Many doubtless remember the treatment of Father 
Kneipp, of Bavaria, which he introduced to the world 
some twenty or more years ago. He was visited by people 
from all parts of the world for the purpose of undergoing 



29 

his special treatment. This consisted mainly in the pa- 
tients baring their feet, and walking over wet grass or 
upon the wet ground, for some little time ; then retiring 
and resting for an hour or two, the length of time being 
dependent upon the strength of the person and other cir- 
cumstances. Although, as I now recall, his treatment did 
not include the administration of medicines, he did insti- 
tute some other form of treatment in connection there- 
with, which I do not think had any therapeutic virtue. 

In connection with the line of thought heretofore de- 
tailed, regarding the passage of the current between the 
earth below and the atmosphere above, the real benefits 
that were derived from Kneipp's treatment by his pa- 
tients (and there were many authentic cures reported) 
were the result of drawing upon the store d-up electro- 
magnetic force in the earth, which was imparted to the 
patient by means of the moist grass or straw, which facili- 
tated the conducting of the current to the patient's body. 

Most remarkable results were claimed for this treat- 
ment, not only in his written reports, which I could not 
doubt to be reliable, but I also learn personally from 
some who had been there under treatment, that cases of 
enlarged liver, rheumatism, and various other forms of 
disease had been cured, after every other mode of treat- 
ment had been tried. One case reported was that of a man 
suffering with dropsy or anasarca. He, of course, did not 
know the reason ; but as a result of taking this treatment 
the patient passed many gallons of water, and was re- 
duced in weight 75 or 100 pounds. My informant stated 
that there were men there, not only from every section 
of the world, but of every station of life ; kings, princes, 
and prominent men of every profession or business were 
taking the same walks in their bare feet over the wet 
ground. 



30 

There have been other systems somewhat similar to 
that practised and originated by Father Kneipp, through- 
out this country, as well as in Europe ; but usually they 
were given empirically, and by unreliable physicians. 

A few years ago, in a certain little park in the suburbs 
of New York, could be seen thousands of men and 
women, suffering from all forms of diseases, and walking 
to and fro, especially after a rain. They walked nearly 
all night. Reports were prevalent that great relief was 
received by many from following this mode of treatment. 

Realizing the great electro magnetic forces of the earth, 
and the changes effected thereby, the writer has con- 
structed apparatus to utilize these forces towards reliev- 
ing morbid conditions, and to restore new vigor to man. 

This apparatus consists of a wire attached to a con- 
ductor extending high in the air, and so arranged as to 
draw the positive electric current from the atmosphere 
high above the earth, and convey it through an insulated 
reservoir containing either medicine, where specific pur- 
poses are desired, or it is simply conducted through this 
reservoir with sufficient resistive force to render it per- 
fectly safe, before being applied to man for special thera- 
peutic purposes. The same general principle is used in 
obtaining and using a current from the earth. 

This instrument is not intended to take the place of 
the special treatment, where organic disease or lesion 
of some organ exists as a cause. Its properties or effects 
consist mainly in supplying defective electro-magnetism 
of one kind or the other when the body is depleted of 
such by over-exertion, either bodily or mental ; or where 
there is defective metabolism, due to a deficiency of 
one form or another of the currents, as superinduced by 
the same disturbances, or from any form of shock, sor- 
row, etc. 



31 

Caution must be exercised in utilizing the earth's cur- 
rent, as well as that of the atmosphere, so as to prevent 
getting an overcharge or shock, that might prove serious 
or even fatal. History gives us an account of Benjamin 
Franklin 's serious shock in experimenting with the light- 
ning rod, by breaking the current from the ground into 
his office, whereby he received the full force of the shock, 
which, although not fatal, was of sufficient severity to 
stun him. 

The writer has experimented with both the atmos- 
pheric and the earth's currents by passing these sepa- 
rately through his body after he had been thoroughly 
insulated, at the same time having within a glass, por- 
celain or rubber container, serving as an insulator, a 
medicament in solution through which the current 
passed before reaching the body, thereby effecting cata- 
phoresis. 

In other instances the current alone was utilized ; when 
a certain polar defect, (positive or negative, depending 
upon attachment to the atmospheric pole or to the earth's 
pole) would remedy a deficiency of the special current 
which was lacking in the body; and in other instances, 
depleted the body of an excess of a certain other kind 
that had so accumulated and been retained as to cause 
hyperesthesia and nervous irritation. This disturbance 
usually affected a ganglion, which by reacting upon the 
central nervous system, resulted in too much nerve agi- 
tation. This latter condition induced an excessive waste 
in animal tissue, causing either depression or excitation ; 
and gave rise to various nervous disturbances, manifested 
by insomnia or disturbed sleep ; this causing one to arise 
in the morning feeling as if he had not been in bed at 
all but had been working all night, and not at all anxious 
for the performance of his daily duties. 



32 



CELLULAR DEVELOPMENT. 



Brief reference to cellular development of organic 
matter pertaining both to animals and plants, is pre- 
requisite to a thorough elucidation of metabolism, or 
constructive and destructive changes of matter. As is 
generally known, all organic matter arises or originates 
from cells. These cells develop only after fecundation 
by processes of division and multiples of division. Some 



ill 





Figure I. 



Figure II. 



plants, like many of the lower order of animals, develop 
either by gamogenesis (sexually) or agamogenesis 
(asexually ) , and some by both processes. Even in agamo- 
genic plants both male and female germs may be pro- 
duced. The development of the plant is somewhat 
similar in its anatomic and histologic construction and 
physiologic function to that of animals. 



33 

The first figure shown on opposite page (taken from 
Luerssen), represents a full developed antheridium (an) 
containing the male germs (mo) of the plant, which are 
pictured as escaping from the antheridium. "When they 
first make their escape, they have the appearance of a 
complete cell, as illustrated by "mo." These latter 
finally rupture, and the germs assume the shape some- 
what of a corkscrew (sp), with flagellum. 

The second figure illustrates the female germ, or 
archegonia (after Strassburger), showing the escape of a 
round cell, oosphere (o) emerging from the archegonia, 
similar to the ovum within the uterus of a female. This 
shows, too, a crude construction of parts somewhat simi- 
lar to that of the uterus, vagina and an exit (labia) 
through which escapes a mucilaginous fluid (m), issuing 
from the mouth of the canal, or crude vagina, whose 
function is similar to that of the mucus of the human 
female. This secretion of the plant is considered by 
botanists to entangle the spermatozoids, as they accident- 
ally come in relation with it; but in fact they are at- 
tracted toward "m" by their electro-magnetic force, 
which is opposed to that of the oosphere ; and after be- 
coming fully developed they make their way to the 
oosphere (o). In the development of the male and 
female germs, the latter precedes the other by some days, 
which is a provision of nature to prevent the spermato- 
zoids that have preceded the female germs, from the 
same species, from impregnating these, in order to pre- 
vent inbreeding or self-fertilization, and to favor cross 
fertilization by being fertilized by a succeeding male 
germ subsequently developing. This preventative meas- 
ure in plants should be a warning against the intermar- 
riage of close kin among humans. It is interesting to 
know by what force the spermatozoids, or male germs, 



34 

reach the oosphere or female germ; and upon this point 
hinges much of what will hereafter appear as a force 
in nature, causing not only chemic action throughout 
the body, both in relation to anabolism and catabolism, 
but also with reference to the various modes of repro- 
duction, growth and the maintenance of life. Investi- 
gation has revealed the fact that the male and female 
germs in both animals and plants vary in electro-mag- 
netic force, and are attractive to one another, by reason 
of their possessing different electro-magnetic properties. 
One may note the peculiar analogy of the anatomic 
and histologic construction of organs (though in crude 
form) of vegetables, as compared with those of animal 
organisms. Their functions are also somewhat similar; 
with the exception that the motor force as directed, by 
way of conveying material for growth and sustenance 
in plants is different from the force which conveys the 
materials of animal life. The vegetable derives its force 
through electro-magnetism, almost exclusively ; by means 
of which various gases, absorbed by the chlorophyll of 
the leaves, are conveyed to the roots ; and the inorganic 
matter being there converted into organic matter is 
conveyed through the same force and conducting media, 




Figure III. 



35 

(the sap), back to the trunk, limbs and leaves, after 
being elaborated at the roots by the convergence of the 
positive and negative electro-magnetic forces. 

The above figure illustrates a longitudinal section of a 
fibro-vascular structure of wood, which shows a number 
of channels, tubes and sheaths as they pass up and down 
through the fibres of a tree, which is somewhat similar 
in arrangement to that of the vessels of the human body, 
with the absence of nerves. The passages scattered 
throughout the structure of the wood, admit of the trans- 
mission of air, or gases. There is also illustrated in this 
same figure, phloem-sheath, which contains cells of 
starchy matter, proteids, etc. In brief, the various chan- 
nels as illustrated show the passage of fluid (sap) which 
dissolves and carries the raw material absorbed by the 
leaves (different gases, C0 2 or carbon-dioxide, nitrogen, 
oxygen, etc.), to the roots. These gases are simply ab- 
sorbed by the chlorophyll of the leaves and are not 
chemically decomposed thereby. It is utterly impossible 
for the coloring matter (chlorophyll) alone to effect 
chemic changes, either by way of analysis or by synthe- 
sis; but the raw materials are conveyed by means of 
the sap to the roots, where chemic changes are effected 
by the decomposition of C0 2 liberating oxygen, and 
converting the carbon into carbohydrates and other sub- 
stances; and, by double decomposition and recombina- 
tions, by way of analysis and synthesis, and by the 
utilization of nitrogen, proteids are formed from the 
earthy salts. 

The various nitrates, sulphates, and chlorates of 
sodium and calcium, or lime salts, exist naturally in the 
soil. Carbonic dioxide is decomposed and utilized by 
the roots of the plant, where it comes into relation with 
these various elements — the carbon uniting in the forma- 



36 

tion of hydro-carbons, and setting free some oxygen; 
oxygen forming new chemic compounds in the plant, by 
combining with nitrogen in the formation of proteids. 

Heretofore, it has puzzled scientists to know how fluids 
and other substances pass from the leaves to the roots 
and back again to the leaves; also they attributed the 
chemic changes before mentioned altogether to chloro- 
phyll and kinetic energy. Yet they have no proof that 
these agents are capable of effecting either analytic or 
synthetic changes. But we do know, and can prove, that 
these chemic changes can and do take place at the roots 
of the plant, where the positive current of the atmos- 
phere and the negative of the earth meet. It has been 
claimed, too, that this material passes from the leaves to 
the roots, and back again from the roots to the leaves, 
mainly by capillary attraction. It is utter folly, with- 
out going into detail, to make such a claim for such a 
force. It is true that, by means of capillary attraction, 
atoms or molecules of water or any soluble chemic com- 
pound will pass one-half to two or three inches probably ; 
but the idea of its passing a hundred or more feet up 
a tree, is unreasonable, and is utterly in violation of 
physical laws, and devoid of proof. It requires no 
stretch of the imagination or theory, to show and prove 
that the passage of an electric current through electro- 
lytes or chemic compounds causes different chemic 
changes by way of analytic decomposition and syn- 
thetic combinations and at the same time the conversion 
of these into fibrous tissue, causing the development and 
growth of the plant or tree. It is also a fact that we 
dp have practically at all times, the passing of an elec- 
tric current from the atmosphere above to the earth 
below. The moisture that accumulates upon the leaves, 
as the result of dew at night, favors the passage of this 



37 

current through the leaves and plant; and at the same 
time, the solution, absorption and conveyance by chloro- 
phyll of carbon dioxide, and other gases through the 
plant in order to develop it by means of the various 
chemic changes in its constructive and destructive forces, 
as heretofore explained. 

THE MOVEMENT OF PLANTS. 

Botanists, as well as others, who have paid special 
attention to flowers, plants, vines, etc., have noted a 
property inherent in climbing vines of being attracted 
to adjacent objects. That is, if a pole or stick be in 
close proximity to one of these climbing plants, the 
plant will make its way to this object, if be a foot or 
more distant. It is claimed by some, that this is a kind 
of instinct or principle inherent in the plant itself. 
Others mention it as selective power. In point of fact, 
it is due to the same electro-magnetic law of attraction 
and repulsion already mentioned; and the stick being 
magnetized, though mildly, by the passage of the cur- 
rent from the air or earth, and this magnetism being 
different from that of the plant, it is attracted thereto. 
This principle has also been plainly demonstrated, by 
means of what is termed the "timber line in high alti- 
tude," as it is a known fact that when the altitude is 
above 11,000 or 12,000 feet, trees and vegetation practi- 
cally stop all vertical growth. Although the same in- 
fluences exist, the moisture and other surrounding media 
being the same as that of trees below this altitude, yet, 
at or above this line, there is a neutral point. By way 
of further explanation, the positive current from the 
atmosphere comes to the earth below that of the negative 
of the earth 's current, or the convergence of the positive 
current with that of the negative takes place below the 



38 

surface of the earth at this altitude. Hence, the surface 
of the earth at this point would be so far distant from 
the positive or negative as to be neutral, and the current 
would therefore be unable to effect chemic changes ; nor 
could it convey the sap, along with its nutritive matter, 
above this neutral point. As the negative current from 
the earth does not pass beyond its point of convergence 
with the positive, it cannot carry substances up the tree 
or plant, so far as it does in lower altitudes. The limbs 
will grow long, and extend out over the earth, but not 
high on the trunk. I have closely observed this fact 
in the high altitudes of Colorado, where large trees even 
six inches or a foot in diameter do not rise to a greater 
height than six or eight feet. This has been a strange 
and unaccounted for phenomenon by the natives and 
by scientists so far as I know, and it is only since dis- 
covering the effect of the atmosphere and earth's cur- 
rents upon vegetation, as well as upon animals*, that I 
have been able to ascertain the true causes. 

This phenomenon also proves the fact beyond question, 
that it is by means of the electric currents passing from 
the earth to the atmosphere, and from the atmosphere to 
the earth, through the media of the trees (especially 
when wet or moist, they then being better conductors 
than the atmosphere), and also through the sap con- 
tained within the channels between the meshes of wood, 
which serve as comparatively good conductors ; by these 
means nutritive material is carried to the tops of trees, 
as well as to the roots below. It is evident, therefore, 
that above "timber line" the trees cannot grow in 
height; they are therefore large in circumference, 
but not tall. This is a very potent fact; and in truth, 
is one of the absolutely postive proofs of the truths 
heretofore detailed, regarding the action of these cur- 



39 

rents and the stored electro-magnetic forces of the earth 
as a storage battery upon organic structures; and 
this action takes the place in trees and vegetation 
of the heart's action in animals. 

CONSERVATION OF ENERGY. 

It is conformable to fact in the conservation of energy 
that light, heat, motion and electricity are convertible 
forces. This may be considered in the same light as 
that of matter being interchangeable into gases, liquids, 
solids, etc., without loss. These materials all exist in the 
human body, under healthy states, in definite propor- 
tions and quantities. When in normal condition the 
body remains constantly at the temperature of 98% F. 
There is no question but that electricity in the human 
body remains normally in a fixed definite quantity 
with reference to positive and negative. Certain condi- 
tions, by way of lesions of organs, causing a perverted 
function and increased action of these organs, which 
excite the nervous system, may give rise to an abnormal 
accumulation, either of both positive and negative cur- 
rents, or that of one in excess of the other. I recall a 
work, which I regret to state has since been lost, pub- 
lished more than a century ago, and far anticipating its 
time, on "The Variation of Electric Tension in the 
Body the Cause of Disease." The author mentioned 
the fact of the depletion of the body, by means of atmos- 
pheric and telluric influences, bringing the positive or 
negative below that of normal, thereby precipitating 
disease. He gave as an illustration, that cholera is very 
rare among men who live in affluence, in houses carpeted 
and protected by insulation; while the poorer class who 
live in huts, and often in houses with the earth as their 
floor, where conditions favor the lowering of a certain 



40 

form of current, thereby are rendered liable to attacks 
of that particular disease. He also claimed that the 
insulation enjoyed by the rich was not wholly beneficial, 
as it gave rise to an excess of current of positive nature, 
which caused (said he), undue oxidation and nervous 
irritation, and rendered the subject peculiarly suscept- 
ible to yellow fever. On the other hand, the poorer 
classes, who live usually much nearer the ground, were 
especially immune from this disease. The idea was, to 
say the least, very ingenious for the time, illustrating the 
depletion or over-accumulation of the positive or negative 
currents, as influenced by certain atmospheric or telluric 
conditions, bringing about these abnormal states, and 
being at least the exciting causes of different diseases. 

Regarding the normal electric current as it exists in 
the body — it is a fact that electricity is evolved at all 
times by chemic combinations, either in constructive 
tissue-formation or in destructive degeneration. It is 
equally true that chemic changes take place in construc- 
tive formation, as a result of the convergence of the 
positive and negative currents. Whether all changes, in 
the way of construction and destruction, result from the 
effect of electricity in the body in definite proportions, 
and by the union of the positive with the negative, and 
in accord with the mandate of the sympathetic ganglia 
controlling the special organ, is a question. "We do 
know that chemic changes take place as a result of these 
conditions, and there is no proof that chemic combina- 
tion results from any other cause. 

It is well known that living in tents which are pitched 
on the ground is conducive to health; this arises, as in 
the instance of Kneipp's patients, from one being prac- 
tically night and day in the closest contact with the 
earth, A hen with a "lost nest" in some out-of-the-way 



41 

place on the ground, hatches out her brood of chicks 
without the loss of a single egg, under the influence of 
the same principle ; whereas a setting of eggs in an 
incubator which is properly insulated from the earth's 
current is seldom sure of being successfully hatched. It 
is an unquestioned fact that incubator chicks are never 
so strong or healthy as those hatched by a hen. Turtles 
deposit their eggs in moist sand — the moisture, acting in 
conjunction with the sun's warmth and the magnetic 
current from the earth never failing to bring about a 
successful result. 

Fishes, . also, thrive while in the streams, subjected to 
telluric influences ; but when placed in an insulated jar, 
it matters not how much they may be fed, they thrive or 
grow but very little, if any. All these illustrations bear 
upon the one point, which has been further noted and 
demonstrated by the writer, in various ways. 

The current always passes from the positive to the 
negative, that of the atmosphere being positive, as 
proven by the phenomenon of lightning always passing 
from above to the earth. Its zig-zag appearance depends 
upon the variations of moisture in the atmosphere above, 
parts of which being comparatively a good conductor, 
while the other part is a poor conductor. It must, there- 
fore, be remembered, that although the surface of the 
earth is considered the juncture of the positive with the 
negative, yet, this does not take place absolutely at all 
times upon the surface of the earth. It may take place 
several feet above or several feet below, depending upon 
the conditions of the moisture of the atmosphere or 
the conducting media through which the current passes 
in its transit from above to the earth. Although it may 
be somewhat convenient to consider the surface of the 
earth as negative, compared to the atmosphere 's positive. 



42 

yet it must be remembered that electro-magnetic potency 
is relative and largely due to internal construction, and 
variations of conductibility. 

To briefly summarize : Nature has provided a force 
which the earth utilizes ; first by vegetative growths, by 
which inorganic substances are decomposed; by means 
of the gases existing in the air, these are brought into 
relation with the inorganic substances of the earth; by 
decomposition and recombination of various molecules, 
new chemic compounds are formed, and by these vegeta- 
tive life or plants transform inorganic substances into 
various intricate organic compounds. 

There is a constant cyclic rotation of changes between 
vegetative growth and animal, one utilizing what the 
other throws off; and where there apparently is a waste 
of substance, by consumption, yet, it is merely conversion 
of one substance into others without any loss of matter. 
This change has been going on ever since the world 
began; and the indications are that it will continue. 

About thirty years ago the prevailing mode of treating 
prostatic diseases was by use of sounds, the knife, the 
Bottini cautery, etc. Having followed the teachings of 
these eminent surgeons for some years with very un- 
satisfactory results, I began experimenting with local 
and constitutional medication, electrolysis, and cata- 
phoresis, for the purpose of stimulating vaso-motor con- 
traction, relieving thereby congestion and inflammation, 
dissipating morbid tissue and chemically decomposing or 
breaking up lime or earthy concretions that form in the 
ducts and follicles. 

I do not wish to convey the idea that I limit treatment 
entirely to medicines, electrolysis, cataphoresis, etc., as 
there are some^few cases in which the use of the knife 
is indispensable. I ain fully aware of the incredulity 



43 

of the profession regarding electrolytic treatment, since 
the use of electricity for medical purposes has for so long 
been in the hands of charlatans. It is true that elec- 
tricity, like other potent therapeutic agents, has been no 
exception to the rule of having had over-enthusiastic 
advocates, who (at first, when its principles were little 
known, and before it had been placed upon a systematic 
basis), claimed for it properties and powers beyond its 
field of utility, and would have had it supplant every 
other mode of treatment. 

Others, whose lack of knowledge of the science of 
electricity is due to the fact that it was not taught in 
the medical colleges at the time they graduated, are 
prejudiced against its use in any form or for any pur- 
pose. They are content to grope in the old, beaten path, 
however unsatisfactory may be the results. 

Even among the practitioners who are using elec- 
tricity, many have gained their knowledge of it from 
ordinary electrical mechanics, instead of from educated 
physicians. These mechanics are utterly ignorant of 
normal therapeutic properties or dangers. They make 
and sell batteries and appliances, and as an incentive 
in promoting the sale of their wares, induce the physi- 
cian to buy and use them for various purposes, telling 
them that "they are perfectly harmless if used according 
to their directions, and, especially if the current is meas- 
ured by their milliampere meters." They do not know 
that there are certain conditions where the use of elec- 
tric currents, whether measured or not measured, is 
attended by irreparable harm. The large majority, if 
not practically all of the books of today written upon 
the subject of electro-therapeutics, in this country, are 
from the pen of some mechanic, who has been selected 
by some prominent manufacturer of batteries, and whom 



44 

they dub "professor" in some medical college. One of 
these ' ' books " ( ? ) , which has had, doubtless, the largest 
circulation of any throughout the country, was written 
by one of these "professors." This "book"(?) is 
offered at any price, or given away when a battery or 
other electrical appliance is bought. Some of the worst 
cases of stricture, inflamed prostates, prostatic abscesses, 
X-ray burns, etc., that have ever come under my obser- 
vation, have resulted from following the instructions of 
this ' l professor " ( ? ) , who is utterly ignorant of the 
existing pathologic conditions, or the means for their 
relief. How is it possible to get definite results, or any 
but harmful, under the circumstances? 

One of these advises in the treatment of prostate ail- 
ments: "Pass a copper electrode down the urethra to 
the prostate, to which attach the positive pole. Turn 
on your current until you get ten or fifteen milliamperes 
and the electrode sticks firmly, then reverse your cur- 
rent, turn on the negative pole till it burns considerable, 
twist the electrode some to loosen it, then hold the nega- 
tive to the electrode until it is loosened. ' ' Now the fact 
is, that such procedure will cause a firm stricture ; be- 
sides, the electrode when thus used will burn almost like 
a red-hot iron, when either the positive or negative cur- 
rent is applied to the electrode. How many men would 
permit the electrode to remain within the urethra five, 
ten or fifteen minutes, burning like a red-hot iron? 
One of these men upon whom the "professor" had oper- 
ated, came to me, and was strictured from the meatus 
to the bladder as a result of such treatment. He said 
the pain was so intense that he could not bear it, and 
screamed for the man to "take the thing out." It was 
pulled out witli great force, bringing the whole lining 
of the urethra out with it; when it was found that "the 



45 

entire insulation on the electrode above the copper end 
was melted off." This gentleman was a skilled mechan- 
ical electrician, and knew something of what had been 
done. Of course, the damage was irreparable, and he 
will suffer the remaining years of his life. 

Following are a few paragraphs from a work on 
"Therapeutics," containing more than seven hundred 
pages, in which the author quotes from another " pro- 
fessor" of "electro-therapeutics": 

"Electro-physiology is that science pertaining to the 
action of electricity on the human body, animals and 
plants." 

' ' Electricity as a factor in medicine is measurable with 
the milliampere meter. It is portable as in case of the 
secondary battery, and many of its various phenomena 
on the human body are manifest. ' ' 

' ' Electricity in mankind, while the cutaneous currents 
in the human being have certain laws made concerning 
the direction in which this current flows, we sometimes 
find the reverse condition exists." 

When we see such nonsensical statements made by 
ignorant "professors of Electro-therapeutics" can we 
wonder at the contumely that is shown towards this 
science by the average citizen, who has neither time nor 
opportunity to investigate its claims? 

In the hands of competent and experienced operators 
electricity is a most potent factor in removing morbid 
conditions, although I have seen some serious results 
follow its application, even by intelligent and prominent 
physicians, who were not quite familiar with the princi- 
ples of electro-physics and the methods of electrolysis. It 
requires experience and tact as well as knowledge to suc- 
ceed in the treatment of these complicated diseases, just 
as it does to succeed in any other line of special practice. 



46 

As man in general has so modeled after and utilized 
the laws of Nature as to have effected great mechanical 
achievements, in like manner has the writer made use 
of her laws, to effect prophylaxis ; to eliminate the ashes 
of the body; to tranquilize nervous irritability; to re- 
move morbid conditions from deep seated organs which 
cannot be reached by any other means except through 
dangerous and often fatal operations ; and ultimately to 
so revolutionize the practice of medicine as to greatly 
relieve all suffering, and prolong life to the extent of 
twenty or fifty years. 

These statements may appear exaggerated and ego- 
tistic to some who are not familiar with my work, yet 
they have not only been attested by hundreds of clinical 
results for many years, but most of these facts have 
been known to thousands of physicians for more than 
two decades, many of whom have taken advantage of 
the knowledge, and have been restored to health them- 
selves, but few have permitted their patients, or others 
with whom they had come in contact, to procure the 
same relief. The following letter is typical of many 
similar which fully attest the foregoing statement: 

New York, Aug. 5, 1912. 

George Whitfield Overall, M.D., 

Chicago, 111. 
Dear Doctor Overall : 

It is because of no lack of appreciation of what you 
did for me when a patient of yours, now four years 
since this month, that I have failed to write you before. 
As you are aware you completely cured me of a compli- 
cation of one of the worst diseases that flesh is heir to. 
Physicians and .'humanity should well feel grateful for 
the great work you are doing. , M.D. 



47 
During the three years that one of my assistants was 
with me, I permitted him to compile statistics of the 
cases we had treated during that time, and give a suc- 
cint history and report of each. 

report. 



Number of cases treated. . .641 

Com. with, cystitis 377 

Carcinoma or sarcoma 

Hemiparesis 5 

Nervous indigestion 57 

Benefited but not cured. ... 46 
Number with gonorrheal 

history 462 

Chronic inflammatory en- 
largement 583 

Syphilitic 5 

Impotency 341 

Interstitial nephritis or 

Bright's disease 3 

Little or no benefit 8 

Number with no gonor- 
rheal history 179 

True indurated hypertrophy 6 

Insomnia 22 

Metastatic rheumatism. ... 63 



Diabetis mel 2 

Deaths 2 

Number complicated with 

vesiculitis 391 

Proctitis 176 

Neurasthenia 37 

Metastatic gon. appendi- 
citis o . . . 3 

Prostatectomy (previously 

performed) 5 

Supra-pub 2 

Perineal 3 

Com. with prostatic ureth- 
ritis 542 

Tuberculosis 1 

Paraparesis 9 

Varicocele 497 

Cures 594 

93 per cent. 



There were only three cases of the 641 treated that 
had interstitial nephritis, though many whose urine was 
loaded with pus, mucus, blood, albumin and sugar 
thought they had Bright's disease. 

Traces of albumin or sugar were in evidence mostly in 
those extremely nervous complications. 

Recapitulation. — Sixty per cent, of males have lesion 
of the prostate gland before they are twenty. Seventy 
per cent, of all men have had gonorrhea and lesion of 
the prostate, resulting from gonococci buried within the 
gland excreting a poisonous substance which is account- 
able for nine-tenths of chronic ailments. 



48 

Ninety-eight per cent of all men past forty have ulcer- 
ation of the prostate ; which invariably causes swollen 
enlargement of the gland if of long standing, when it 
begins to dam up nature's greatest sewer, and a series 
of grave troubles follow in rapid succession. 

Emboli, and other debris resulting in infarctions, 
cause serious and often fatal results — these deaths occur 
as a rule very suddenly. Emboli and other forms of 
debris are absorbed through the prostatic and other 
ulcers or lesions, and are carried to the heart, the brain 
or the kidneys, causing more sudden deaths than all 
other etiologic factors combined. The more-recently 
discovered lesions described in the book have been ascer- 
tained to be the precursors of more obscure serious 
disturbances, such as neurasthenia, degenerations of 
heart, kidney, or brain, than any other cause. Vaso- 
motor disturbances, resulting from the various lesions 
(including prostatitis, urethritis, etc.), cause/ under one 
condition, excessive alkaline secretion. As a result of 
this condition calcareous deposits form in the pelvis 
of the kidney, prostate, and gall bladder. When these 
are of long standing, and too large to pass out through 
the various ducts, they become dangerous, and often 
necessitate an operation that may have a fatal result. 
Under other conditions vaso-motor disturbances pro- 
duce acetonaemia and general acid secretions, result- 
ing in uric-acid, synovitis, pericarditis, arachnoiditis, 
pleuritis, precipitating many premature deaths, the 
origin of which is never known. 

For many years the attention of the entire world has 
been directed towards the enactment of laws for the 
enforcement of sanitation and prophylaxis against ' ' The 
Great White Plague"; while apparently neglectful of 
"The Great Black Plague," the ravages of which bodes 



49 

greater evil to family and state than any other one 
disease to which the human race is subject. It is the 
opinion of the writer, who has given almost one-third of 
a century to the special study, practical observation and 
treatment of this particular disease, that (taking into 
consideration the remote effect of this latent germ and 
its malevolent influences that affect the genito-urinary 
organs), they cause infinitely more direct and indirect 
complications, sufferings and deaths than any other one 
disease. In truth, it is rare for any chronic ailment, 
functional or organic, to exist for any length of time 
that it is not caused by, or does not become complicated 
either directly or remotely with some form of disturb- 
ances of these organs. 



CHAPTER I. 

Brief Descriptive Outline of Anatomy and Histology 

of Nervous Systems, so far as Pertains to 

the Following Chapters. 

causes and diagnoses of disease. 

The sympathetic and ganglionic system of nerves 
have never received the attention that their importance 
demands, either as regards their functions or from a 
pathologic point of view. 

These ganglia direct and control all the vegetative 
organs in the body, and each organ has a separate and 
distinct ganglion or plexus controlling it. When over- 
taxed they become specially susceptible to morbid con- 
ditions, which may result in functional disturbance, or 
even lesion. The various works upon physiology that 
the writer has noticed, refer to these ganglia as capable 
of working incessantly, or "both day and night," as 
they term it, without rest. This is an erroneous idea, 
as all organs require from one-third to two-thirds, 
mostly the latter, of time for rest, as compared with the 
one-third they work. This error, doubtless, is one reason 
why these organs have either been neglected or entirely 
overlooked from a pathologic point of view. 

It is an incontrovertible fact that all organs become 
congested during their state of activity, or during their 
working hours. Should the duration of their work be 
extended by morbid excitation, the congestion is no 
longer normal ; but, on the contrary, there is a tendency 
to stasis or morbid congestion of the organ ; and should 

51 



52 

this exercise or work be incessant, the congestion results 
in irritation, and ultimately lesion follows. This applies 
to any organ in the body. There are two reasons why 
the sympathetic ganglia become functionally disturbed 
or pathologically involved more than any other organs. 
The first reason is that they are so constructed and ar- 
ranged, by way of close anatomic connection, that lesion 
of any organ not only affects the ganglion controlling 
this particular organ, but this disturbing effect is trans- 
mitted to other ganglia in close proximity, which also 
become disturbed, and at the same time causes disturb- 
ance, and even lesion of the organs they control. The 
second reason is, that the coccygeal and sacral ganglia 
control organs which are more frequently involved in 
functional disturbance, and even lesion, than any other 
organs in the body, with the exceptions probably of the 
kidneys and prostate gland. 

Figure IV illustrates the double chain of sacral 
ganglia in the pelvic region, which becomes primarily 
affected more frequently than any other ganglia or set 
of nerves in the entire body. This is due to the fact 
that it controls and presides over organs which are more 
exposed. The lower one, "c," the coccygeal ganglion or 
ganglion impar, is probably the most important, for its 
size, of the ganglia of the entire nervous system. It is 
this ganglion that first becomes disturbed when there is 
ulceration of the rectum, hemorrhoids, py-ro-saks, over- 
ticula, or disease of the bladder, prostate and urethra ; 
being in such close relation to the ganglia controlling 
these organs that sympathetic disturbances frequently 
occur. Functional disturbance of this ganglion or lesion 
thereof is transmitted through the double chain to the 
sacral ganglia above. The disturbance of this ganglion 
is not only fel^ throughout the entire ganglionic chain 



53 




Figure IV. 

extending up through the abdominal, thoracic, and cer- 
vical regions, but even the brain is influenced by this 
one little ganglion. In making this statement I am 
influenced more by its clinical aspects than by consid- 
eration of its relations with the other ganglia. There 
have been many cases of dyspepsia, insomnia, and men- 
tal disturbances, relieved by simply finding a lesion of 
an organ which is controlled by this little coccygeal 
ganglion. 

Continuing upward from the first sacral ganglion on 
each side of the spinal cord, there is a continuation of this 
chain of ganglia throughout the abdominal, thoracic and 
cervical regions, and even within the cranial cavities. 







Figure V. 



55 

Figure V illustrates a continuation of sympathetic 
nerves radiating from these ganglia on each side of the 
spinal cord, forming the hypogastric plexus just below 
the stomach, then passing upward to the inferior mesen- 
teric and spermatic to the great solar plexus, or ' ' abdom- 
inal brain," as it is often termed. 




Figure VI. (Quain.) 



56 

Figure VI, taken from Quain, illustrates still further 
this double chain of ganglia, as well as the numerous 
sympathetic fibres, in the regions of the kidney, bowel, 
stomach, heart, liver, and in fact all the internal visceral 
organs. This figure illustrates, also, how intimate is the 
relation and connection of any one of these visceral 
organs with all the others. It also shows the various 
blood vessels, the large aorta, as well as its subsidiary 
branches, which are controlled and often disturbed by 
an excited function or an organic lesion arising from any 
organ controlled by these ganglia. 




Figure VII. 

Figure VII illustrates the immense number of nerve 
connections in the region of the prostate, the rectum 
and bladder, as well as the external genital organs. 
Special attention is directed to this cut as points in 
diagnoses will, arise frequently, resulting from nervous 
irritation of parts of this region. Itching in this region 



57 




NE 

Figure VIII. 



58 

is pathognomonic of lesion of some organ adjacent there- 
to, which lesion may be of sufficient gravity as to shorten 
one's life. It is Nature's flag to warn of impending 
danger. 

Figure VIII illustrates the construction of nerve cells 
forming these different ganglia, as well as of the nerve 
cells composing the gray matter of the brain. This cell 
is magnified four to five thousand diameters; so to get 
an idea of its size we must imagine at least four thou- 
sand of these cells in every square inch. "N" points 
to the nucleus of the cell; "PA" the parenchyma, while 
"S" illustrates the sheath surrounding the cell. These 
cells have one, two or more poles, which serve to con- 
nect the cells to one another, and some of these poles 
extend on out, forming nerve filaments, as "PO." These 
poles are made up of the central axis and insulating 
sheaths, which are continued around the nerve filament. 
One may note the marked similarity of the construction 
of a ganglion to that of a galvanic battery ; and how the 
nerve passing from a ganglion may transmit nerve force 
from two thousand or five thousand or more nerve cells. 
These small nerve filaments have each a separate sheath 
and insulating material, just as the cord of a battery 
is protected by an insulating cover. The nerve itself 
has finally a covering, as is illustrated, that passes on 
until these filaments are given off separately at their 
destination. 

Figure IX illustrates the great sciatic nerve as it 
makes its exit from the abdominal cavity out over the 
hip. As it crosses downwards on the posterior part of 
the limb, it gives off several large branches. The nerve 
finally breaks up into small filaments and terminates in 
cells of a, highly sensitive nature. These cells, "S C," 
illustrate the manner in which practically all sensory 



59 




Figure IX- 



60 

nerves terminate. They are about the same size as 
brain cells, varying from one four-thousandth to one 
five-thousandth of an inch in diameter. Close observa- 
tion of this nerve, and of its terminals, will greatly 
facilitate the diagnosing of many obscure cases; as it 
arises from practically all the sacral branches of the 
spinal nerve "S C" and receives filaments from the 
sacral ganglia. These latter are so often involved from 
lesions of the genital organs, the rectum, bladder, sem- 
inal vesicles, that they constitute an index as to where 
to look for the seat of the trouble. This is almost in- 
variably a lesion of one or other of the organs just 
mentioned; and relief of these organs gives permanent 
cure to the sciatica, the "bete noire" of the medical 
profession. I cannot at this time recall a single case 
that has not been entirely cured by removing the cause 
as found in one of the organs before mentioned. 

The calf of the leg, or the popliteal space, are the 
most frequent locations indicating trouble, although it 
may be manifested in any point of this nerve. I have 
had several cases where the symptoms were manifested 
in the heel only; other cases were in the big toe or 
the second toe. Atrophy of the leg and even paralysis 
is common in cases where this nerve is involved. 

Having illustrated and briefly described the functions 
and locations of the principal ganglia that preside over 
the general vegetative organs of the body, I shall now 
illustrate the manner in which they affect the cerebro- 
spinal or central nervous system. 



61 




Figure X. 



62 

Figure X gives a diagrammatic illustration of the 
brain, spinal cord and certain areas therein, as well as 
the nerves passing to and from the central nervous 
organism. "I. S. C." and "G-. S. C." diagrammatically 
illustrate respectively the intestinal nerve center and the 
genito-spinal center, as they exist within the spinal cord. 
Natural impulses arising from the sigmoid flexure are 
transmitted to the special sympathetical ganglion, and 
from there to the I.C.S. center in the spine. Impulses 
arising from the prostate or genital organs are directed 
to the prostatic ganglion, thence to the G.S.C. or genito- 
spinal center. Should cognizance be taken of such an im- 
pulse, it is transmitted up through the sensory tracts 
"S. E." as the arrows indicates, to "(XT." the optic 
thalamus, or sensory nerve center. Should the impulse 
not be noticed it stops there, but on the contrary should 
cognizance be taken of it, it is transmitted from "0. T." 
to "B. C," the reasoning center of the brain, and should 
further notice be taken of it, it is transmitted from 
"R. C." to "X C." the idealization center of the brain, 
by which it is reasoned about or seriously considered. 
If further action is taken it is transmitted from "X C." 
to "C. S." the motor center, and down through the 
motor tract from "C. S." to the organ or muscle im- 
mediately concerned, by which action, as determined, 
is taken. 

There often arises lesion of the sigmoid-flexure or of 
the rectum, when reflex irritation is transmitted to the 
ganglia controlling these organs, thence to the "I. S. C." 
or spinal center controlling these organs indirectly; the 
continuous reflex irritation arising from the ganglia is 
transmitted to the spinal center " I. S. C, ' ' until finally 
there ensues effusion, abnormal congestion and stasis of 
this spinal center. Paraplegia may result from this, 



63 

although, at a point somewhat higher than the ' ' G. S. C. ' ' 
which would be extended in a similar way to that of an 
involvement of the "G. S. C." and as a result there 
would be paralysis of the lower limbs, impaired function 
of at first, one arm, then disturbed memory, and general 
conditions similar to those that follow that of the 
"G. S. C." 

One peculiarity clinically observed in some cases, 
where there existed an involvement of the prostate and 
disturbance of the genital organs, was a peculiar compli- 
cation between a lesion of the sigmoid-flexure and the 
"I. S. C." of the cord; which has proven, more from a 
clinical point of view than from any other, that the 
" G. S. C. ' ' and the " I. S. C. " are in close relation. This 
special disturbance referred to was manifested by ex- 
cessive and unnatural priapism. This condition has 
been observed not in a few cases only; many cases of 
the kind have convinced the writer that these centers 
are closely related in the spinal cord, as cure of the 
sigmoid has relieved the priapism. 

Figure XI (G) represents the prostatic ganglion, 
and nerves passing to (P. P. P.) prostate, and to the 
two nerves passing to the spinal nerves (b and d) ; 
(v), seminal vesicles; (R), rectum; (c), genito-spinal 
center; (b), nerves running from (a) ulcer; to (c) 
genito-spinal center; (d) nerve reflected from G. S. C. 
(c) to rectum, vesicles, bladder, etc., which transmit 
nervous irritation (arising primarily from the lesion in 
the prostate gland) and cause various morbific states, 
as impotency, paraparesis, paraplegia, etc. These con- 
ditions are common as results of lesion of the prostatic 
urethra, of the prostate itself, or of the neck of the 
bladder. 

The urethra, prostate and adnexa, which include the 



64 




Figure XL 



rectum, bladder, and vesicles, primarily, and the dia- 
phragm, kidneys, lungs, heart, etc., secondarily, are the 
organs that are involved in morbific changes more fre- 
quently than are any other in the entire human system. 
All the vegetative organs are in close proximity, and 
their functions are mutually interdependent and cannot 
be disassociated. In other words, lesion affecting any 
one of these organs invariably brings about either func- 
tional disturbance, or ultimate lesion, of other organs, 



65 

sometimes located far therefrom. The vaso-motor sys- 
tem always becomes affected, and naturally is associated 
with disturbances of the heart and general circulation. 
By noting the immense distribution of the sympathetic 
nerves arising from the various ganglia to these organs, 
we can at once see how a disturbance in any one organ 
brings about involvement of the others. 

Lesion of any organ in the pelvic cavity may be trans- 
mitted to its ganglion, and thence reflected to the spinal 
center, causing first congestion, stasis, and often effusion 
at this particular point. It may then give rise to soften- 
ing or degeneration of this spinal center, or result in 
the formation of a cicatrix, which would leave a perma- 
nent lesion and probably permanent paralysis of the 
spine. 

By way of practical illustration we will suppose (as 
frequently happens), that one has a lesion or an abra- 
sion, either within the prostate, at the neck of the blad- 
der, or within the rectum — there arises a constant 
excitation of the ganglion controlling the prostate, the 
bladder, or the rectum. This ganglion transmits its 
impulse uninterruptedly as arising from this sore to 
the spinal cord at (c) (Figure XI). This genito-spinal 
center becomes first congested normally, then congested 
abnormally, and as a result there is an effusion of fluid, 
in and around the spinal cord, at this center, (c). This 
causes either impaired motion from the hips down, or a 
sudden paralysis of the lower extremities. Should relief 
of this sore at the prostate take place by proper treat- 
ment, bringing about abatement of the congestive irri- 
tation of the ganglion "G," then the fluid around the 
spinal center at (c) would become absorbed before lesion 
took place in the spinal cord, and restoration to perfect 
health would ensue. But should no relief to this sore 



66 

take place, and there is continuation of the same reflex 
irritation, this center would become permanently con- 
gested, or statis would take place, and ultimately hemor- 
rhage occur, cicatrix form, and permanent lesion would 
result. At this final period, should relief of the gland 
not take place, there never could be a perfect restoration 
of normal conditions to the spine, because this cicatrix 
or scar tissue would have become hard and firm, and 
adhere to the spinal membranes ; and little or no benefit 
could result from treatment thereafter. The spine would 
gradually become involved above the lesion at (c) and 
ultimately the loss of the arms (generally the left at 
first), then impaired memory, and finally a lingering 
death. 

As the "ganglionic brain' ' or sympathetic nervous 
system exerts special influence over the various organs 
in health and in disease, and becomes reciprocally in- 
volved in all their various conditions, brief reference 
will be made here to the functions of the two different 
nervous systems found in the human body, that we may 
be enabled to note the pathologic conditions, as well as 
the functional relations of these two important nervous 
systems, separately, and in their relations toward each 
other. The brain (cerebrum) and spinal cord, or the 
cerebro-spinal nervous system, only controls those organs 
which are under the direct influence of volition, or will ; 
while the ganglionic controls all the vegetative organs. 
That is, one can, by the exercise of his will, command the 
arm to bend or the limbs to move ; but he cannot com- 
mand the stomach, the prostate, and similar organs to 
act. 

While there is no direct connection between the cere- 
bro-spinal nervous system and the ganglionic nervous 
system, yet the nerves of one are so intimately blended 



67 

with those of the other, and the sympathetic ganglia 
and cerebro-spinal centers are so intimately related, that 
lesion of any organ which is controlled by one nervous 
system, is indirectly influenced by, and influences the 
other. All the organs of the body, which are directly 
concerned with the maintenance of life, are controlled 
by the sympathetic ganglia. These ganglia are aroused 
to activity only by intrinsic or extrinsic excitation. By 
way of illustration, suppose the vesicles ("v" Figure XI) 
become filled with semen. This fact is not transmitted 
directly to the cerebrum, or brain, but to the prostatic 
ganglia (G) (the sexual brain) ; thence directly to the 
prostate gland (P.P.P.) where sensual emotions arise. 
If further notice be taken of this impulse, it is trans- 
mitted to the genito-spinal center (c) of the spinal cord, 
thence up the spinal cord to the brain, or cerebrum. 

Again, suppose there is a lesion, such as a py-ro-sak, 
and transmission of the irritation thereby set up, to the 
fourth sacral ganglion; from here the sensation is con- 
veyed to the hypogastric ganglion and finally to the 
spinal center controlling this particular organ — in this 
event, instead of normal conditions prevailing, there 
arises a continuous nervous excitement, produced by this 
lesion, which is transmitted to the spinal center and 
up through the sensory tract to the receptive and ideal- 
ization centers of the brain. There then ensues a 
persistent irritation of these latter centers, causing in- 
somnia or a restless nervous state which is at times 
unbearable, when there should be perfect rest and 
quietude. The sufferer arises in the morning feeling 
"all used up" and as if he had not been to bed at all. 
Or this may so affect the hypogastric or epigastric 
plexus, as to bring about a nervous disturbance resulting 
in indigestion where either an acid or an alkaline excess 



68 

produces acid eructations or gaseous formations. These 
conditions, which are merely symptomatic, as a rule are 
not treated, as one would naturally think they would be, 
by first ascertaining their cause and then taking steps 
to remedy these, but repeated doses of bicarbonate of 
soda or some other alkali are prescribed, the effect of 
which is to fill the body with alkaline deposits. The in- 
effective efforts of nature to eliminate these deposits when 
they have become too great to be thoroughly dissolved in 
the bodily fluids, results in their precipitation and deposi- 
tion in the blood vessels (rendering these hard and brit- 
tle), pelvis of the kidney, gall bladder (in which two 
latter they cause calculi to form), the skin, and the 
various tissues which Nature has provided for their 
elimination from the system. 

There are other instances where lesion of the prostatic 
urethra affects certain ganglia, which effect is trans- 
mitted to the vaso-motor center, and as a result there is 
an excessive alkaline urine accompanied by nervous dis- 
turbances. This alkaline constituent of the urine often 
becomes so excessive as to accumulate, and is deposited 
within the various tissues. 

On the other hand, there may be a lesion in close 
proximity to that giving rise to excessive alkalinity of 
the blood that will give rise to disturbance of a special 
ganglion, which in turn so disturbs the vaso-motor sys- 
tem as to cause acetonaemia or an acid condition of the 
blood, which is accompanied by a retinue of acid secre- 
tions and especially of the urine, which condition is 
termed "uric acid diathesis" and is dosed for indefi- 
nitely, without effort being made to remove the cause. 

This acid condition gives rise to morbid conditions of 
all the serous membranes within the body. The mem- 
branes which first become involved, as a general rule, 



69 

are the synovial of the joints, causing what is termed 
"rheumatism"; then follows in direct line, the serous 
membranes of the heart, which often causes serious dis- 
turbances of that organ, and especially of its mitral 
valves; often the cavities of the heart also become in- 
volved. Laymen, as well as physicians, know that heart 
disease is somehow connected with rheumatism, and most 
of them think that rheumatism causes heart trouble. 
There is no connection between rheumatism (or synov- 
itis) and heart disease; but the same condition (that 
of acetonaemia) that gives rise to rheumatism or synov- 
itis causes also the serous membrane of the heart to 
become affected, as heretofore described, giving rise to 
endocarditis; then the serous membrane enveloping the 
lungs by way of the pleural sac becomes affected and 
gives rise to an irritative cough that is mistaken for 
tuberculosis, bronchitis, and various other lung troubles. 
It is often the case that men and women suffer for years 
with such a cough, frequently unattended (at first at 
least) with any expectoration, that arises simply from 
irritation of this pleural sac. Eelief of the local trouble 
entirely dissipates the cough. 

In some instances, the disturbance of the ganglion that 
has given rise to an excessive alkaline urine often also 
affects certain nerves, and especially those of the origin 
of the sciatic nerve ; and strangely enough this disturb- 
ance is transmitted down the sciatic nerve to the heel. 
In other instances, it is transmitted to the big toe only; 
then again to the second or third toe, when there is no 
other symptom pointing to lesion of the gland, other than 
this one symptom. There have been cases treated by the 
writer, where complaint was made of no symptom other 
than pain in the heel, pain in calf of leg, pain in big toe, 
or pain in the popliteal space. Often the patients would 



70 

insist that they had no trouble with the bladder, with 
the prostate, or any of the genito-urinary organs. 

Case I. The patient for some time refused to have an 
examination made. When he did consent, on being 
questioned, he acknowledged having had gonorrhea sev- 
eral times. His prostate was exceedingly inflamed — and 
although three or four treatments gave great relief, he 
insisted on leaving for Hot Springs, Ark., "where he 
had procured instant relief several times before." The 
Hot Springs treatment on this occasion, however, aggra- 
vated his condition, the pain in the big toe becoming 
so excruciating, that he had the toe removed. The pain 
at once jumping to his ankle, the foot was removed ; the 
pain went to the calf of the leg, and became so intense, 
that hypodermic injections of large doses of morphia 
failed to give relief. He then insisted upon removal of 
the leg at that point, which was accomplished under 
general anaesthetics, when the pain became located in 
his knee and was unbearable. Relief could not be pro- 
cured except under the influence of chloroform ; and the 
patient insisted upon the knee being cut off. He was 
so weak by this time, that the operation was performed 
without an anaesthetic, when he stated that the removal 
of the leg was attended with less pain than that which 
he had suffered before. He died a few hours after this 
operation. A second case of this kind occurred to the 
knowledge of the writer, where a man had suffered 
intense pain in his toe for two or three years. He con- 
sulted several neurologists in succession, none of whom 
could give any but temporary relief. He finally went 
to one whose theory was that there was too much blood 
in the toe ; and so impressed the man, that he agreed to 
wait six weeks with his foot elevated above his body, to 
favor the return flow of blood. This was accompanied 



71 

by pain as severe at the end as it was in the beginning. 
Added to this was almost completely broken health. At 
this time he consulted the writer, when relief of the 
prostate completely cured his toe in less than six weeks. 

The writer has doubtless appeared to be very redund- 
ant in giving so many illustrations of the interaction of 
the ganglionic-nervous system, but there are so many 
symptoms arising from causes and lesions remote from 
the apparent seat of disturbance that he wishes to em- 
phasize the fact that one must be familiar with the 
action of all the different ganglia and their relations 
with each other in order to form a correct diagnosis — 
and the chief aim of diagnosis, is, after all, to discover 
the cause of disease. Observations in cases of hay fever, 
sciatica, difficulty of breathing, chronic cough, shortness 
of breath, insomnia, neurasthenia and various other 
troubles of similar character, for example, have inva- 
riably shown that they could be traced to such lesions and 
other causes remotely situated; and the removal of the 
cause has so invariably resulted in relief of these ail- 
ments that we cannot ignore the numberless facts that 
day after day clinically prove the close connection exist- 
ing between the lesion and its observed effect. 

When the causes have been located and removed, there 
is but little left for the physician to do in the way of 
curing his patient. 

TOXIC SOURCES OF DISEASE AND PREMATURE SENILITY. 

There are four channels through which the ashes or 
catabolic products are eliminated from the body : namely, 
the lungs, the skin, the bowels, and kidneys. The former 
two are of little importance from a pathological point 
of view, as the carbon-dioxide and salts eliminated by 
the lungs and skin are practically harmless. 



72 

The author is a strong believer in the germ theory, 
and, in fact, knows that it has done much toward clear- 
ing up many obscure diagnoses. Physicians are often 
misled by taking cause for effect, unaware of all the 
conditions pre-requisite for the development and propa- 
gation of germs. 

All bacteria, or germs, whether of vegetative or of 
animal origin, may be compared to an ordinary germ, 
cell, or seed. There are three conditions absolutely es- 
sential for their development. These three conditions 
are: first, heat; second, moisture, and third, food (soil 
or culture). 

Heat and moisture are always present in the blood. 
The other necessary condition (food for the bacteria) 
is obtained especially from the damming up of toxic 
matter at the neck of the bladder, and also from the 
obstruction of similar matter in the bowel (resulting 
from disease of the sigmoid), from pus sacs, overticula, 
pelvis of the kidney, etc. 

These toxic products contain practically all the pro- 
teids or albuminoid substances which are among the 
most virulent of all poisonous materials, and they are 
constantly being absorbed into the circulation. They 
thus help to maintain the blood in a condition suitable 
for the development and propagation of toxins, toxal- 
bumins, auto-intoxication, etc. 

In the absence of the toxic food necessary to the 
production and sustenance of bacteria, the germs of 
pneumonia or of any other acute or infectious disease 
which have passed into the blood by way of the lungs 
or any other route would necessarily perish and there 
would be no such disease develop. 

By way of illustration of the development of bacteria, 
or vegetative germs, suppose a seed, or grain of wheat 



73 

is subjected to the proper amount of moisture, and to a 
temperature of from 70 to 90 (F.) degrees; placed upon 
a stone or rock, it will sprout, but never develop. But 
under similar conditions of moisture and heat, if placed 
in a fertile soil, it will germinate, propagate, and pro- 
duce its kind. The same is true of any other vegetable 
or animal microbe. 

WHAT WE READ IN THE PAPERS. 

The following appeared in a recent issue of the Chi- 
cago Tribune in the "Medical Advice Column : 



? ? 



Mrs. North Side writes : ' ' I have read nothing in 
your articles relating to my kind of indigestion — 
that is, acidity after eating ordinary food, belching 
of gas, etc. I have cut out coffee at intervals, sub- 
stituting tea, but cannot detect much difference, if 
any, in my sjnnptoms. I eat toasted bran or whole 
wheat a day or two old, and keep my bowels open 
by taking a teaspoonful of Carlsbad salts every 
morning. I do lots of exercising, but not in the open 
air. "What can I do beyond avoiding rich food? 
And what do you think about having my stomach 
washed out every day ? I am 40 years old and have 
been bothered this way for years, but more so since 
having my appendix removed three years ago. ' ' 

Reply. — You probably have a nervous indiges- 
tion, which dieting, washing the stomach, and sim- 
ilar procedures generally hurt about as much as 
they help. The best cure of all is the service of a 
stomach specialist with personality. A negative 
minded, scientific stomach specialist who analyzes 
and talks chemistry is as useless as a bump on a log. 
A stomach specialist, to help his patients, uses per- 



74 

sonality, plus. Nervous indigestion, acid stomach, 
needs a specialist who leads the mind away from 
the stomach. The next best aim is to cure the con- 
stipation, which is practically always present. "When 
this can be done by bran, vegetables and agar, to 
use them is better than to use Carlsbad salts. Fre- 
quently, dyspeptics, in trying to avoid this, that, 
or the other food, eat so as to bring about constipa- 
tion and thus they promote dyspepsia indirectly. It 
is better to eat with more freedom and less thought. 
The next best aid is exercise in the open air. 
Here is a prominent physician directing a woman 
who evidently has a special lesion to take treatment from 
a specialist of personality, plus, for an indefinite period. 
Bran acts only by local irritation; and if there is, as is 
most probably the case, ulceration of the sigmoid or rec- 
tum the bran aggravates the irritated ulcer, and the 
disease constantly grows worse, until finally the patient 
dies during a paroxysm of acute indigestion, superin- 
duced by the bran or perhaps one of the various pre- 
pared foods which has been prescribed by the attending 
physician, although most of these prepared foods are 
known to be deprived of nearly all the nutritive com- 
ponents in the process of manufacture, and otherwise 
doctored. I do not think there is any doubt that "pre- 
pared foods" and the poisonous substances which are 
added to make them attractive to taste are responsible 
for many of the disturbances of the digestive tract or 
entire alimentary canal. 

It is quite common for physicians to advise removal 
of the appendix for the relief not only of nervous in- 
digestion, but of every form of obscure disease; yet the 
writer confidently affirms that he has not ever seen a 
single case of removal of the appendix where the indi- 



75 

vidual was sound or healthy thereafter. Often have I 
learned of people who have been rendered much worse 
by the operation in question. I shall make the bold state- 
ment, that during the last fifteen years I have had 
numerous cases of " appendicitis " traceable to other 
lesions, and that not one failed to be entirely cured on 
removal of the cause. I believe, too, that ninety-nine 
per cent of cases suffering with typhlitis and other dis- 
turbances of the colon and bowels can be cured by the 
same process of treatment. 

There is another point which I cannot forbear men- 
tioning in connection with prepared foods and the pois- 
onous substances which are often added to every-day 
foods, and that is the addition of formalin to milk. That 
this is one of the most potent factors of serious results 
has been clinically proven many times by the writer. 
Long continued use of formalin, even in minute doses, 
causes an acid condition of blood with all its retinue of 
injurious effects by way of inflammation of serous mem- 
branes, bringing about articular synovitis, endocarditis, 
pleuritis and various other troubles of organs contain- 
ing serous membrane. Milk and other foods containing 
formalin and other injurious drugs are given to young 
infants and cause early breakdown of their vital organs, 
so impairing their health before reaching maturity as 
to render them incapable of resisting the various patho- 
logical influences that arise in later life. So positive am 
I of the deleterious effects of formalin that I never use it 
personally, not even in my coffee. Even when prescribed 
by a physician it is often contra-indicated ; and when it 
is indicated it should never be given more than three or 
four days in succession. 

The following excerpt from the Pennsylvania Journal 
of Feb. 2, 1913, is worth reading in this connection: 



76 

"Sixteen boys, all stricken with appendicitis at 
abont the same time, operated upon within a few 
hours of one another, and all the patients holding a 
reception at the same time today is the unique rec- 
ord of St. Mary's Hospital here (Philadelphia). 

"The boys, ranging in age from 10 to 16 years, 
were inmates of St. Francis Industrial Home, a few 
miles outside of Eddington. Ten days ago the 
youngsters began to complain of pain in that por- 
tion of the anatomy where the appendix should be. 
' ' The resident physician of the home diagnosed the 
cases as appendicitis, and began to rush the patients 
to St. Mary's Hospital here. At St. Mary's, Dr. 
S. D. K., the resident physician, also diagnosed the 
cases as appendicitis. Dr. E. K. did likewise. 

"After the sixteen boys became hospital patients 
their condition became worse. It was decided that 
operations were necessary to save the lives of the 
boys. That was six days ago. 

"Dr. K. and Dr. K. rolled up their sleeves and 
started in. As soon as one youngster was removed 
from the operating table, another took his place. 

"Dr. K. and Dr. K. declared that epidemic ap- 
pendicitis was brought on through overeating of 
cheese. " 
Drs. K. and K. surely had here fine opportunity to 
practice their art; but this maiming of sixteen young 
boys should be requited by condign punishment upon 
the offending doctors. "We are getting more enlight- 
ened every day ; and some of the Western states are even 
now considering the advisability of interdicting the oper- 
ation altogether and providing a severe penalty on 
anyone who performs such a barbarous and unnecessary 
operation. 



77 

Another instance of the insane craze for the removal 
of the appendix was reported in the Chicago newspapers 
of Aug. 23, 1913, as follows : 

"Robert Scerzino, 11 months old, 2614 W. Huron 
street, was operated upon at the American hospital 
last evening for appendicitis by Dr. M. T. and was 
assisted by Dr. M. F. The child is the youngest 
person ever operated upon for the disease, according 
to medical authorities. ' ' 

diagnosis. 

Diagnosis is recognized as perhaps the most important 
and most difficult of the medical branches. Even so 
eminent a diagnostician as Dr. Abbot publicly declared 
that only about 50 per cent, of his own diagnoses were 
corroborated by the autopsies held afterwards, although 
these cases included some which "a tyro in medicine 
would record at a glance." 

Some of the most difficult ailments with which the 
profession has to deal are those of so-called neurasthenia, 
nervous indigestion and various other forms of nervous 
disturbances manifested as insomnia, melancholy, de- 
fective memory and different forms of sensations arising 
in the back of the neck, top of the head down the limbs 
to the fingers, toes or heel, disturbed vision, ringing in 
ears, tingling of fingers, paresis of the arm or lower limb, 
sciatica as manifested by darting pains in the limbs, 
especially in the popliteal space and calf of the leg, etc. 
Many cases have come to the writer with similar symp- 
toms to those above enumerated and he has succeeded in 
clearly tracing them to lesions of various organs, as 
explained. 

In summing up, I wish to state that I am prepared to 
prove by clinical demonstration, every statement made 



78 

in these pages regarding the cause, diagnosis and cure of 
the different diseases mentioned in the preceding and 
following pages. 

The main features in diagnosis in the great majority 
of cases are more thoroughly elucidated in the clinical 
reports that follow, than they could be in any other way, 
as the tracing of symptoms to their sources in the differ- 
ent lesions will enable us to more clearly understand the 
main diagnostic points, and the means of relieving them, 
than by means of a dissertation upon Diagnosis itself. 

THE OSTEOPATHS. 

Certain "wonderful cures" produced by "distin- 
guished physicians" have sometimes been brought to the 
notice of the writer, when in fact the physicians in 
question were guilty of doing nothing more than manip- 
ulating the spine or the abdomen, whereby they relieved 
certain symptoms, but did not remove the cause which 
had produced these various disturbances. A number 
of cases treated by myself had previously passed through 
the hands of some one or other of these "chiropathic" 
physicians — one of the most noted of whom was a few 
months ago discharged from his position as brakeman 
on a railroad. After being discharged he studied chiro- 
pathy, obtained his diploma and is now practicing as a 
full-fledged physician — all this in a few months. 

The osteopaths reap their harvest by manipulations of 
the spine ; whereby they reach, in a measure, the double 
chain of ganglia which extends through the pelvic, ab- 
dominal and thoracic cavities; by their manipulations 
they also give temporary relief to the great abdominal 
brain, constituting the semi-lunar ganglion, or solar 
plexus. The various lesions which have been noted by 
the writer, give rise to disturbances in these various 



79 

ganglia; and although the osteopaths often give tempo- 
rary relief only, it most frequently happens that the 
patients are more than satisfied with the really unsatis- 
factory results, and continue to spend their hard-earned 
money in preference to having their stomachs dosed year 
after year with poisonous coal-tar preparations and 
other medicaments equally as destructive to the blood 
corpuscles, until they become almost bloodless or, as 
often happens, die without knowing what their trouble 
was. 

A prominent physician of Chicago, living in one of 
the most aristocratic parts of the city, called upon the 
writer, delivering samples of medicines for a prominent 
drug manufacturer. I asked him if he was practising 
medicine. He reluctantly replied that he was ; and in an 
injured tone stated that he was necessitated to accept a 
position with this drug house to deliver these samples 
the first of every month in order to assist him in making 
a living. He further stated that four-fifths of the people 
in his vicinity were Christian Scientists. I asked him 
if he had any cases of acute indigestion, and how he 
treated them. He replied affirmatively, and said that he 
gave "lactopeptin" and various digestive preparations. 
I said, "Doctor, do you ever make a physical examina- 
tion to note the cause of the trouble V 9 " Oh, no ! ' 9 I 
made the same inquiry regrading prostatic troubles, 
cystitis, pyelitis, etc. The same reply was given ; that he 
would write prescriptions without making any physical 
examination. I then said to him : ' ' Can you censure 
these people for not permitting you to dose them, from 
day to day, month to month, and year after year, with- 
out knowing the real cause? Is it not much better to 
depend upon Christian Science than to take remedies of 
that kind, which ultimately would bring about serious 



80 

trouble?" He left feeling quite indignant at my im- 
pertinence! I mention this case especially, as coming 
under my own observation; and it really illustrates the 
conduct and tactics of medical practitioners of today. 



CHAPTER II. 

Brief Outline of Anatomy and Function, as Per- 
tains to Our Subject. 

Of the various classes of diseases from which men suf- 
fer, none is of more frequent occurrence, none has more 
baffled the skill of the physician, or tried the patience 
of the sufferer, than that of the prostate and adjacent 
organs. The frequency with which this gland is af- 
fected has been variously estimated by genito-urinary 
specialists; some holding that from twenty-five to fifty 
per cent, of men suffer from its disease, others claiming 
that it is an exception to find a man past forty with a 
healthy prostate gland. 

When we note the highly sensitive organization of the 
gland, its psycho-sexual relation, its exposed position 
to the bladder, rectum, kidney, and seminal vesicles, and 
the fact that it is pierced by the urethra, the prostatic 
and the ejaculatory ducts, and that, moreover, it is fre> 
quently subject to excessive tax or abuse, we cannot 
wonder at the frequent functional disturbances or 
organic diseases incident thereto, the various nervous 
disturbances arising therefrom, and, owing to its in- 
accessibility, the obstacles to be overcome in its treat- 
ment. 

The prostate is a musculo-glandular organ enveloped 
in a fibrous capsule. It is situated at and embraces the 
neck of the bladder. It is about the size and shape of 
a horse chestnut, with its base directed towards the 
bladder and its apex in front. It lies upon the rectum, 

81 



82 



being separated therefrom only by loose fascia. Its 
transverse diameter at the base measures about one 
and one-half inches, its antero-posterior diameter (which 
corresponds with the length of the prostatic urethra) is 
about one and one-quarter inches, and its depth three- 
quarters of an inch. 

It consists of two lateral lobes of equal size. Some 
writers mention a third or middle lobe, but this exists 
only with true indurated hypertrophy and then as a 
pathological condition. The urethra passes through the 
anterior third of the gland, though occasionally through 
the middle or posterior third. 




Figure XII (Henle). 

Figure XII shows the relation of the prostate to the 
bladder and prostatic urethra. The floor of the latter is 



83 

a very complicated and highly sensitive structure and 
bears an important relation to the gland, both from a 
functional and pathological viewpoint. In fact, it is 
really a part of the prostate itself. 

In the center and longitudinal direction of the floor 
is a small eminence (9), the verumontanum, or caput 
gallinaginis. Somewhat in front and in the middle 
of this eminence is a small cavity, the utricle (11). 
Special attention is called to this little cavity, as it often 
becomes enlarged and is then apt to engage the end of 
a small bougie, catheter, or other instrument while being 
used. On attempting to pass such an instrument into 
the bladder, it may become arrested, and so cause one 
to make an erroneous diagnosis. Force should never be 
used with any instrument, or false passages may be 
made. On each side there is a slight fossa, into which 
the ejaculatory (10) and prostatic (12) ducts open. 
(3) points to the ureter which passes down from the 
kidneys and enters the bladder upon its posterior wall, 
passing through it in an oblique direction and beneath 
the mucous lining of the bladder ; which mucous lining 
serves as a valve to prevent regurgitation of urine back 
into the ureter when the bladder is filled and distended. 
The urine percolates down beneath this mucous surface 
into the bladder even when it is full. 

The floor of the prostatic urethra is the most sensitive 
part of the entire genito-urinary tract and is considered 
the seat of the sexual orgasm. It is subject to patho- 
logical lesion more than any other portion of the urethral 
canal, owing to its complex structure, and to the fact 
that it receives the irritative secretions of the prostate 
and seminal vesicles, when these latter organs are af- 
fected. It is, in fact, an index of no little importance to 
the condition of the prostate. 



84 

The orifices of the ejaculatory ducts or utricle often 
become dilated when disease of the prostate or vesicles 
exists, and are apt to engage the point of a small instru- 
ment, in an effort to force an entrance into the bladder, 
and becomes arrested, when a larger instrument will pass 
over these orifices and enter the bladder with ease. 

Beneath the fibrous capsule of the prostate is a firm 
band of unstriped muscular fibers surrounding the base 
of the organ and deflected downwards towards the apex. 
The same fibers radiate throughout the gland in the form 
of trabecular, forming meshes, through which the vessels 
and nerves ramify. Interposed between these meshes 
there are also numerous follicles that secrete a milky, 
alkaline fluid, which passes out through the prostatic 
ducts upon the floor of the urethra. The main function 
of this prostatic fluid is to maintain alive the germs or 
spermatozoids until they reach their destination. "When 
the gland becomes inflamed or diseased, this fluid natur- 
ally becomes inert and useless ; or serves to destroy these 
germs by its septic condition, and thus renders them 
infertile. I have often noticed by clinical observation 
that men apparently healthy are sterile, which occurs 
oftener than defect in the opposite sex. 

The arteries are derived from the internal pudic, 
vesicular and hemorrhoidal, which are branches of the 
internal iliac. 

The veins form plexuses around the base and sides of 
the prostate, bladder and rectum, communicating freely 
with the hemorrhoidal and spermatic veins, and the 
dorsal vein of the penis and pampiniform plexus. Thus 
the organs from which they arise, namely, the rectum, 
spermatic cord, epididymis and penis, are brought into 
close physiological and pathological relations with the 
prostate. ' Passive congestion or stasis of the veins of the 



85 

latter cause a clogging of the veins of the rectum re- 
sulting in ulceration or hemorrhoids ; or, when the sper- 
matic veins are involved, varicocele follows. 

NERVES. 

The nerves supplying the prostate are very numerous 
and highly sensitive. Those derived from the sympa- 
thetic system are supplied by the prostatic ganglion, and 
the hypogastric and pelvic plexuses, as illustrated in 
Figure VII. 

FUNCTION. 

The prostate is an important genital organ, possessing 
the triple function : a, of expulsion of semen by means 
of the rhythmical contraction of its muscular fibers; b, 
of being the nerve center of the orgasm ; c, of secreting, 
through its glandular structure, a fluid essential as a 
vitalizing agent to the spermatic germs. 

It is in this gland that the pleasurable sensation of the 
orgasm is located; the sensation being synchronous with 
the expulsion of semen. It is by this gland that the 
physiological impulse to gratify animal nature is indi- 
rectly exerted through the sympathetic and cerebro- 
spinal nerve centers. In fact, the gland has been appro- 
priately called the seat of the sexual brain. The inti- 
mate reciprocal relations of the cerebro-spinal centers 
and the prostate are very marked, both in health and 
disease. 

In health, excessive mental exertion, as by close study 
or business cares, will lessen the sexual appetite ; while 
violent emotions, as grief, fright or anxiety, will tem- 
porarily suspend all desire. 

Men are by nature* much more sensually inclined than 
women; and when they cultivate libidinous impulses. 



86 

and associate with prostitutes, are liable to indulge their 
sexual propensities to such an extent as to develop pas- 
sions that may lead to grave moral vices, like excessive 
intercourse or masturbation, resulting in lesions of the 
prostate, or adjacent organ, or indirectly to some serious 
form of nervous disease. 

Just as mental disturbances influence sexual condi- 
tions, so in like manner do diseases of the prostate gland 
cause such various forms of mental disorders as inact- 
ivity, depression and numerous other neurotic aberra- 
tions. 

I have especially noticed that men between the ages 
of forty and seventy, suffering from chronic prostatitis 
mentally become sluggish and inactive. 

Owing to the contiguous relations, the direct source 
of blood supply, and the intimate connection of the 
nerves of the prostate, bladder, seminal vesicles and rec- 
tum, disease of the prostate cannot exist any great length 
of time without causing either functional disturbance or 
organic disease of the others. Besides, inflammatory 
disease of the prostate often arises from chronic rectal 
troubles. 



CHAPTER III. 

Acute Prostatitis. 

This form of disease of the gland usually results from 
harsh treatment of gonorrhea, by means of strong injec- 
tions, large doses of copaiba, turpentine or cantharides, 
or from injudicious use of instruments and methods of 
treatment. It frequently follows injudicious treatment 
of chronic diseases. In fact, acute troubles often super- 
vene upon chronic inflammation of the prostate or blad- 
der, even when the greatest care is exercised in the 
treatment. However, this will be more fully explained 
in subsequent chapters. The gland swells very rapidly 
and is extremely painful. The inflammatory condition 
usually extends to the seminal vesicles, bladder, and 
often the entire pelvic viscera, giving rise to marked 
pain in the region of the perineum, rectum and groins. 

Dysuria is excessive and is often attended with inces- 
sant tenesmus. The attack is usually ushered in with a 
chill, which is followed by mild pyrexia. The desire to 
void urine is frequent and uncontrollable, the patient 
passing but a small quantity at a time. The irritation 
often extends to the rectum and bladder, giving rise 
to a sensation of fullness, a desire to remain at stool 
and incessant desire to void urine. The latter symptoms 
are especially prominent when vesiculitis exists. Or- 
chitis often supervenes, greatly adding to the discomfort 
of the patient. On the appearance of the first symptoms 
of the latter trouble, the patient should be placed in 
bed at once and remain there for several days or he 

87 



88 

is liable to be confined to bed for several weeks or even 
months. It is the only treatment in such cases to avoid 
a long, continued, painful sequel. 

Treatment. — The treatment consists mainly in pallia- 
tive measures, by way of rest in bed, anodynes in the 
form of hyoscyamus, opiates and hot hip baths. The 
diet should be light and consist mostly of demulcents, as 
of barley water, which is especially indicated ; soups and 
other light nourishment. All injections or specific medi- 
cation should be discontinued. 

Urethral instrumentation is strictly interdicted, unless 
there are indications of retention of urine. Should it 
be necessary to evacuate the bladder by catheter, which 
is seldom the case, a full dose of morphia should be ad- 
ministered half an hour previously thereto, per the 
rectum. Rectal suppositories of boric acid, belladonna 
and opium give great relief. The bowels should be 
maintained in a laxed condition by means of saline 
cathartics. 

In from five to fifteen days the urethral discharge is 
re-established, unless complicated with orchitis, and gen- 
erally becomes quite profuse. This is followed by defer- 
vescence and the subsidence of all acute symptoms. At 
this stage I advise the free use of a five per cent, solution 
verbascol in distilled water, to be injected deeply into 
the urethra, from four to five times daily, with an 
ordinary sized gonorrheal syringe having a blunt point. 
I never advise a long nozzled syringe, as it often serves 
to perpetuate urethritis near the meatus. This treat- 
ment readily relieves all acute symptoms. 

Should the discharge continue excessively and longer 
than a week, after the subsidence of acute symptoms, I 
add one grain of sulpho-carbolate of zinc to the ounce of 
distillecf water or the injection before mentioned. 



89 

When complicated by orchitis, rest in bed is impera- 
tive. Local applications of belladonna and hamamelis 
with cold applications to the swollen testicle give relief. 
Never under any circumstances paint the scrotum with 
iodine or any other irritating substance, as this only 
serves to increase the inflammation. I also deprecate 
the use of bandages to prevent swelling, as this latter 
is nature's effort to relieve the soreness and tenderness. 
Anodynes should be the chief remedies given internally. 

All acute symptoms gradually subside under this 
treatment, leaving a chronic gleety discharge, which is 
a "flag" to indicate chronic inflammation of the pros- 
tate or vesicles, and will be considered in the succeeding 
chapter. 



CHAPTER IV. 

Sub-acute and Chronic Prostatitis, with Granulated 

Urethritis, Vegetative Growths, Proud 

Flesh, Cystitis, Vesiculitis. 

This affection of the gland is one of the most com- 
mon diseases with which men between the ages of 
twenty and seventy-five suffer. It is quite difficult to 
draw a line between sub-acute and chronic diseases of 
the prostate, as there are conditions and symptoms 
common to both. A strict boundary line, however, can- 
not be drawn, with reference to age, in any class of 
diseases of the prostate. There are occasionally cases of 
chronic prostatitis that occur earlier than the twentieth 
year, while others are met with even past seventy-five 
without there being any perceptible enlargement of the 
gland. 

Figure XIII illustrates the most common form of the 
beginning of acute prostatitis, as well as of sub-acute or 
chronic prostatitis. The red part indicates the site of 
the lesion. 

In the earlier stages of the trouble (the sub-acute) 
the inflammatory condition is confined to the ducts and 
follicles of the gland; but when of long standing it 
becomes diffused and involves the parenchyma of the 
entire organ. Ordinarily there is little or no swelling 
of the prostate in the early stages of this disease. The 
bladder, seminal vesicles and rectum are rarely involved 
in a sub-acute stage ; in the chronic stage, however, 
these organs are usually involved. In some aggravated 

90 



91 




Figure XIII. 



cases of both forms, the inflammation extends to the 
vesicles, ampulla, vas deferens, epididymis or the globus 
major and minor. When the latter are affected small 
worm-like lumps can be felt at each end of the testicles, 
which are then usually tender to the touch. 

Congestion of the pampiniform and hemorrhoidal 
plexuses of veins almost invariably result: the former 
causing varicocele, especially upon the left side, while 
the latter gives rise to a swollen condition of the rectal 



92 

mucous membrane resulting in protrusion, ulceration or 
the formation of pile tumors. These conditions are 
sequels to prostatic inflammation and not idiopathic dis- 
eases ; and the cause producing them should be remedied 
before treating the symptoms, or all phases of the disease 
should be treated at the same time. 

Figure XIV illustrates the most common condition 
resulting from an old chronic case of gonorrhea, or a 
chronic condition of inflammation of the neck of the 
bladder, whether due to gonorrhea or other causes. 
This condition also frequently follows glandular en- 
largement of the prostate, but does not often follow true 
hypertrophy. In Figure XIV, P.F. points to where the 
trouble originates. It shows the beginning of an ulcer or 
lesion, which culminates in the above condition, causing 
proud flesh or vegetative growths to form and to fill 
up completely or in part the canal at the neck of the 
bladder. This condition is often mistaken for hyper- 
trophy of the prostate. Inflammation often extends up 
into the bladder as shown by I.N., which points to the 
enlarged and congested state of the blood vessels. This 
is one of the most common of all chronic troubles with 
which old men suffer, and it causes swelling of the 
prostatic gland, just as an ulcer of long standing upon 
the finger, the limb, or any other part would cause it 
to swell. P. illustrates where this gland has become so 
swollen as to project into the rectum. The membrane 
surrounding this gland becomes very tense, and the 
gland feels hard; this causes the disease to be often 
mistaken for true hypertrophy. It is easily cured by 
proper means; and it does seem criminal to remove the 
prostate gland, which is so serious and dangerous an 
operation. Ninety-five per cent, of the cases can be 
cured without endangering life, and the organ left in 



93 




Figure XIV. 

a normal state, by my methods, whereas the best of 
surgeons at present cannot present a better average 
of cures than one-third. 



ETIOLOGY. 



The most frequent cause of this form of disease of the 
gland is chronic gonorrhea, but it is not, as many physi- 
cians believe, the only one. On a liberal estimate, about 
seventy-five per cent, of these cases are traceable to 



94 

gonorrhea as the source of the trouble, while twenty-five 
per cent, are due to other causes. Moreover, it is not a 
fact that the gland becomes affected only by mal-treat- 
ment of gonorrhea, as is usually the opinion of the 
patient, who is often encouraged in this view by rival 
physicians, as he "goes the rounds." It generally fol- 
lows treatment even by the most skilled physicians, and, 
too, in cases where the patient exercises the greatest 
care. The common opinion of both laymen and physi- 
cians is, that a patient suffering from chronic gonor- 
rhea may be declared to be " cured " when the acute 
symptoms have subsided and the discharge ceased. As 
a matter of fact, the ordinary method of treatment is 
by no means an effective one. The prostatic urethra 
and the prostatic ducts are almost invariably left in a 
chronic congested and often ulcerated condition, after 
the cure is supposed to be complete. 

These remaining conditions require for their perma- 
nent cure the special local treatment devised by the 
author. 

It is this one chronic trouble (prostatic urethritis fol- 
lowing acute gonorrhea in men) that authentic reports 
have proven to be the cause of seventy per cent, of all 
blindness, and of seventy-five per cent, of all diseases of 
women. "When such serious troubles are entailed by 
this disease, there should be a law passed which should 
imperatively insist that all men and women should be 
entirely cured of this sequel to gonnorrhea before being 
permitted to marry. This law should be rigorously en- 
forced, although it would temporarily postpone four- 
fifths of all marriages. 

' ' 'Tis true, 'tis pity ; and pity 'tis, 'tis true. ' ' 

Unfortunately, the writer has to add, that judging 
from the reports of his patients (and this is corroborated 



95 

by others' experience), there are indeed very few physi- 
cians in practice who possess the knowledge and the 
means for properly treating and finally curing the 
chronic troubles in question. 

The condition of the prostatic urethra, described 
above, resulting from these diseases, leads to the gravest 
sequelae in the form of chronic gleet, swelling of the 
gland, inflammation of the seminal vesicles and the 
entire retinue of troubles which, it is now considered 
by physicians, give rise to much more serious trouble 
than any other one disease, including syphilis. 

Prior to the discovery, by Neisser, in 1879, of the 
specific germ of gonorrhea (which he christened "gono- 
coccus"), the medical profession were very much puz- 
zled as to the cause, tenacity and complications of this 
disease. Such early authors as Selle (1781), Hunter 
(1786), Fournier (1806), Ricord (1836), Foucart (1846) 
and Brandes (1854) claimed that there was a direct 
relation between gonorrheal urethritis and rheumatism 
that occurred in conjunction therewith. 

Guyon (1836) and Thiry (1856) advanced the theory 
that gonorrhea developed a latent rheumatic diathesis. 
Guerin (1846) and Laseque (1876) held that gonorrhea 
was a disease, sui generis, with a long period of incuba- 
tion. Lewin (1878) advanced the theory that gonorrheal 
rheumatism was due to reflex irritation from urethritis. 

Bernultz and Noeggerrath, long before the discovery 
of the specific coccus, held that chronic gonorrhea in men 
was accountable for many of the ailments in women, 
who never had a true gonorrhea and whose troubles 
could not be traced to any other source. 

The true nature of cause and effect was never clearly 
understood by any of these great authors; although 
many of them knew that there was some relation or 



96 

connection between gonorrhea and chronic diseases such 
as synovitis or rheumatism and also with other chronic 
troubles occurring in women as well as in men. The 
facts, as we now know and understand them, are that 
the sequelse of gonorrhea are due to the passing of these 
gonorrheal germs (gonococci) into the prostate gland, 
through the prostate duct, and through the ejaculatory 
duct into the seminal vesicles, causing these organs to 
become involved, and greatly complicating the ultimate 
cure. It is due to this fact that the author insists upon 
the last stage of gonorrhea being cured, so as to stop 
the germs at this point, instead of permitting them 
to invade the prostate gland through its ducts, and 
the seminal vesicles through the ejaculatory ducts. 
When they get into these organs they are practically 
immune to the ordinary means of cure, and can only 
be reached by the special agents and methods devised 
by the writer. 

Like most great discoveries, that of Neisser was met 
with strenuous opposition, until confirmed by the in- 
vestigations of Bumm, Baumgarten, Finger, and many 
others in rapid succession. 

I shall not discuss here the various means of scientific 
research leading to the final establishment of the fact, 
which is now recognized as a proven postulate, that the 
gonococcus is a facultative micrococcus (schizomycete), 
found free in the purulent discharge of gonorrhea and 
within the substance of the pus cells. The latter feature, 
together with the fact that it does not stain with iodine, 
are two of its most characteristic diagnostic points. 
Various diplococci are often present, so closely simulat- 
ing gonococci that the different methods, as staining, 
culture growths, etc., have all to be used before a definite 
differential diagnosis can be established. 



97 

The gonococci, in common with most of the other 
micrococci, are anerobic and thrive only in a neutral or 
alkaline medium, and at temperature of from 30° to 
40° C. They feebly resist an acid medium, and in such 
have an ephemeral existence. Paradoxical as it may 
seem, considering the tenacious manner with which this 
microbe clings to its victim, it is a delicate germ and 
readily succumbs to the effect of many germicidal agents, 
when brought in direct contact with them ; but the gono- 
coccus is so minute that it conceals itself within the 
pus cells, subepithelial cells, the lacunas of Morgagni, 
Littres glands, the prostate and vesicles, and is out of 
reach of germicidal remedies as ordinarily used. 

Up to the time of the discovery of the gonococcus the 
remedies in use were directed, mainly in an empirical 
manner, towards controlling the purulent discharge, it 
being unknown at that time that the pus cells carted 
away millions of the gonococci, which were the true 
source of the disease. 

Keersmaecker and Verhoogen (followers of Oberland- 
er) say, "the gonococcus is extremely sensitive to desic- 
cation.' ' * * * "It is hidden in the depths of the 
tissues and is protected against destructive agents." 

The gonococci are first implanted, fostered and propa- 
gated at or near the meatus, in a medium and locality 
most favorable for their development. They multiply 
very rapidly, work their way along the urethra, and (in 
spite of all measures to prevent it), to the prostatic 
part; thence directly into the ejaculatory and prostatic 
ducts and follicles. The orifices of these ducts being 
open gateways, though their walls are in apposition, offer 
no resistance to the passage of the germs into the chan- 
nels of the prostate and ejaculatory ducts, where they 
become hidden within the follicles of the gland, and are 



98 

thereby protected from destructive agents as applied 
through the urethra by the usual methods. The course 
is also an open one to the seminal vesicles and vas 
deferens, to which they occasionally gain access. 

The cylindrical epithelium of the urethral mucous 
membrane is the normal abode of the gonococci. Here 
they remain active and aggressive, but after leaving this 
their indigenous soil for that .of the prostatic and 
ejaculatory ducts, they become lethargic and do not 
wander very far upon alien ground. Hence they us- 
ually do not pass further than the interior of the 
prostate. 

The authoritative estimate of the proportion of all 
gonorrheal cases where the germs invade the prostatic 
ducts and follicles, is placed at from seventy-five to 
eighty-five per cent. ; those that invade the vesicles, at 
from twenty to thirty per cent. ; and the vas deferens 
from ten to fifteen per cent. This is about the propor- 
tion as demonstrated by the author's clinical experience, 
though the late fad of stripping the vesicles would place 
gonorrheal invasion of the vesicles at a much higher 
ratio. 

It is a positive fact, as proven by various pathologists 
in their examinations of prostatic expressions, that the 
prostate is the chief abode of the latent gonococci; 
authorities differ upon the subject as to whether the 
germs themselves subsequently penetrate cellular tissue 
and the walls of blood and lymph vessels; or whether 
they remain dormant within the prostate secreting 
toxins, which latter are absorbed by these vessels and 
carried to remote parts of the body effecting metastasis, 
as manifested by " rheumatism, ' ' synovial arthritis, 
or neuralgic pains in various parts of the body. Linde- 
man, Young and others claim that the affection of the 



99 

nerves and joints is the result of the gonococci carried 
to these parts by the blood currents from a lesion 
localized in the genito-urinary tract. Bumm, Baum- 
garten, Neisser, Bochart, Gerbardt and Hartley main- 
tain that metastatic diseases of the joints and nerves 
are the result of mixed gonorrheal infection. Guyon, 
Janet, Furbringer hold that these diseases follow as 
a direct result of ptomaine poisoning from the inva- 
sion of the gonococci into the tissues. There are 
others who advocate similar views all tending to the 
same result. 

The author concludes, after summing up the opinions 
as expressed by the numerous investigators along this 
line, and recounting his own investigations and clinical 
experience, that metastasis is the result, in the majority 
of instances, of the toxins of latent gonococci that orig- 
inate within the prostate as result of the secretion of the 
germs ; and it is only in those cases where an abrasion of 
tissue in the genito-urinary tract ensues that the cocci 
themselves enter the circulation and are carried by the 
blood currents to remote parts of the body. When the 
latter occurs and the cocci are deposited within the joints, 
nerves, etc., they readily die, as it is a proven postulate 
that they cannot live outside of mucous surface, and the 
disintegration of their cadavers intensifies local metas- 
tasis. 

Taking either view, however, the question of vital im- 
portance is practically the same ; which is, that the germs 
are concealed within the prostate, vesicles, or urethra, 
and if the gonococci can be destroyed in these organs, 
it stops the generation of toxins. 

Clinical experience has convinced me that both of 
these views are correct. However, the metastatic dis- 
eases are much more often the result of the toxins se- 



100 

creted or produced by the cocci in the prostate and 
conveyed by the circulation to the various tissues in the 
body, than to the presence of the gonococci themselves 
in the tissues. The latter condition rarely, if ever, exists 
unless there is some marked abrasion in the mucous lin- 
ing of the urethra, prostate, or vesicles, even then, should 
the cocci be transported from the prostate to the various 
tissues of the body their lives would be ephemeral, 
because it is proven that they cannot live except in a 
mucous surface. 

Many observers have reported the discovery of diplo- 
cocci resembling closely gonococci, which would decolor- 
ize by Gram's Method, and where cultures would pro- 
duce a urethritis of three or four days' duration but 
not a true gonorrhea. The writer has noted many 
similar cases, from clinical observation, and has been 
thoroughly convinced that these germs are non-virulent 
gonococci, rendered sterile by their having remained 
dormant for so many years within the prostate or 
vesicles. 

During an acute exacerbation of prostatitis, causing 
excessive discharge within the urethra, these latent cocci 
are swept along with the discharge and at times set up 
a urethritis of short duration, but they lack sufficient 
vitality to create a true gonorrhea. But, should the 
cocci enter the blood current, phagocytosis would be the 
most probable result, or, coupled with the lethal effect 
of blood serum upon the germs, they could scarcely 
escape destruction. Moreover, it is an indisputable fact 
that gonococci cannot live except within a mucous mem- 
brane, and, should it be possible for them to escape the 
destructive agents before mentioned, in their transit 
along the blood currents, it would seem impossible that 
they could live sufficiently long, outside of a mucous 



101 

surface, to effect metastatic pathogenesis, except by pois- 
ons resulting from their death and decay. 

I dwell upon this point at some length because the 
question is an important one, and one that is presented 
almost daily in active practice, in regard to obscure 
chronic diseases. 

Should these germs be carried to various parts of the 
body, and, if it were possible for them to live indefinitely 
as they do within the mucosa of the prostate, but few 
who have had gonorrhea could withstand their ravages. 
Besides, it would be impossible to reach them, if scattered 
over the entire body, with destructive agents that would 
not prove fatal to the patient. 

The columnar epithelium of the mucosa within the 
prostate being in close histological relation to that of the 
urethra, serves to perpetuate the lives of these germs bet- 
ter and longer than other mucous surfaces, though they 
do not propagate therein. The mild alkaline reaction of 
the prostatic secretion also ministers to the maintenance 
of their lives. 

The writer believed, as he stated in the third edition 
of his book, that the toxins secreted by the gonococci 
were absorbed and carried by the circulation to the 
various tissues of the body, and there set up the various 
chronic diseases with which we have to contend. But 
more recent investigation and clinical facts have proven, 
without doubt, that these toxins affect certain organs, 
which in turn give rise to disturbances in certain sym- 
pathetic ganglia ; and that these ganglia excite vaso- 
motor changes that give rise to either acid or alkaline 
conditions. These conditions ultimately produce synov- 
itis, and affections of other serous membranes in the 
heart, lungs, etc. Certain other lesions, induced by these 
toxins, give rise to a different perverted vaso-motor 



102 

condition, that effects an alkaline secretion and causes 
conditions reverse in character to those which are caused 
by acetonemia. These facts have been so often proven 
that the writer has been compelled by clinical results 
to adopt this conclusion as axiomatic. 

Clinical results following the treatment of the pros- 
tate, together with frequent examinations of the pros- 
tatic expressions, have convinced me that the prostate 
is the chief abode of the latent gonococci. I have traced, 
in numerous instances the origin of remote arthritic and 
neuralgic pains indirectly to the prostate, by destroying 
the hidden germs within the gland, which were evi- 
dently the fons et origo malorum, and which was evi- 
denced by the immediate disappearance of all symptoms. 
The destruction of the gonococci within the prostate 
having suppressed the generation of the toxins, and the 
poisons being no longer carried through the lymph and 
blood channels to the tissues, all pain would disappear 
and recovery would be rapid. On the contrary, were it 
probable that the gonococci had lodged and remained 
alive, within the joints and other tissues, instead of 
their toxins, local treatment of the prostate would not 
relieve the condition, and it would be impossible to do 
so where polyarthritis existed. 

Serous and synovial membranes and nerves are espe- 
cially marked for the morbific effects of the toxins of 
gonococci. The pathological changes that occur as de- 
nouement of the toxins, in the joints and serous cavities 
produce conditions favorable for the development of 
diplococci or streptococci, that closely simulate gono- 
cocci; which has given weight to the theory of the 
extensive migration of the latter. 

O^ing to the tenacious sequels of gonorrheal infection, 
it is the opinion of many physicians that, when one once 



103 

has gonorrhea, it is never entirely eradicated; and that 
it is attended with greater fatality than syphilis 1 . The 
latter view is generally conceded, taking the sequels of 
gonorrhea into consideration. 

Prostatic expressions have shown gonococci to be pres- 
ent in the fluid for many years after complete subsidence 
of all gonorrheal symptoms. Some writers claim they 
have discovered latent gonococci in the gland as long 
as sixteen or even thirty years after its invasion. 

The past decade has been prolific of much research 
as to the habits, life and pathogenesis of these germs, 
which has been the means of clarifying obscure diagnosis 
in many instances; and especially since the discovery of 
their hiding place in the prostate. 

Furthermore, these germs may remain dormant secret- 
ing toxins that penetrate and maintain an inflamed pros- 
tate, but not effect metastasis for a long period, yet cause 
reflex neurotic disturbances. 

When the gonococci have entered the prostate, they 
begin the secretion of toxins, which at first cause sub- 
acute, then chronic inflammation of the follicles and 
ducts, and subsequently parenchymatous affection of the 
entire gland ; which maintains a constant muco-purulent 
discharge that is poured out upon the floor of the 
prostatic urethra. This secretion must necessarily pass 
along the canal toward the meatus. The discharge may 
be so slight as to appear only as the "morning drop/' 
or it may become desiccated by the warmth of the 
urethra, and noted only by the gluing together of the 
lips of the meatus in the morning ; or it may even escape 
observation altogether. Then again, the discharge may 
become quite profuse at times as influenced by excita- 
tion, by dissipation or other causes, and continue, re- 
gardless of all injections, sounds or caustic applications 



104 

to the deep urethra, or constitutional medication; as 
such treatments do not penetrate the ducts to reach the 
seat of the trouble. 

The gonococci may remain hidden within these deep 
tissues for years in a latent state, unless, by certain irri- 
tative conditions, as induced by ~bacho et venere, a 
copious prostatic discharge is excited, and the germs are 
carried by the excessive secretion into the urethra, where 
they may become auto-inoculable, and set up a fresh 
although mild attack of gonorrhea, or a plain urethritis. 

It has also been demonstrated that these germs may 
remain dormant for three or six years, or even longer, 
when, under certain conditions, they may become 
aroused to activity and manifest their pathogenesis; 
though not in as virulent form as the prime attack. 
Numerous instances have come under the author's obser- 
vation where, even among married men, there was un- 
mistakable evidence that latent gonococci had been 
aroused to activity, developing an acute urethritis which 
could not be traced to another origin than that of auto- 
inoculation. 

OTHER CAUSES. 

During erotic excitement, whether normal or ab- 
normal, the prostate becomes hyperemic, either synchron- 
ously with or independent of penile erection. If this 
excitement is unduly prolonged, by toying with women, 
indulging continuously in libidinous thoughts, associa- 
tion with prostitutes, masturbation, continence or exces- 
sive intercourse, it causes venous stasis or congestion of 
the gland, resulting ultimately in sub-acute or chronic 
prostatitis which readily extends and involves the pros- 
tatic, ^urethra and adjacent parts. This condition pro- 
vokes a prostatic discharge similar to that of gleet and 



105 

is often mistaken for such. This discharge being poured 
out within the urethra, induces prostatic urethritis in 
the same way as do the toxins of gonorrhea, and may 
extend the entire length of the urethral canal, rendering 
it tender and supersensitive. Many times have I known 
such conditions treated many years for gonorrhea, when 
there were no indications of the latter disease. 

It is somewhat difficult to define just what constitutes 
excessive sexual indulgence, as individuals vary so much 
in their physical organism and sexual propensities. 
What would be excessive and injurious to one man, 
might not be to another. 

Masturbation. — In addition to its local baneful effect 
upon the urethra and gland masturbation is attended 
with an excessive drain upon the nervous system, and 
is more apt to provoke some form of mental disturbance, 
owing to the absence of the natural psychical stimulus 
of the opposite sex. 

The evil effect of masturbation upon the prostate and 
vesicles primarily, and the nervous system secondarily, 
has been over-estimated by many, and treated with too 
much indifference by others. The fact of the almost uni- 
versal practice, at some time of life, among males, 
renders it a convenient source to which to attribute all 
the sexual and nervous diseases, not traceable to gonor- 
rheal origin. 

Charlatans reap a rich harvest among youths and, 
too, older men, who, being over-sensitive, are too prudish 
or secretive to consult their family physician and fall 
an easy victim to their tenets and ruse. The family 
physician is often accountable for this; not making a 
thorough examination of the case when consulted, treat- 
ing the matter with too much indifference, and dis- 
missing the patient with a tonic, or telling him it is 



106 

' ' all in his head. ' ' The fact is that most of those 
addicted to the habit are so ashamed of it, that they will 
deceive the physician, by denying the practice alto- 
gether, or minimize the extent of indulgence so as to 
mislead him. 

Objective symptoms alone, as revealed by an examina- 
tion, can determine the extent of the lesion as induced 
by the vice. I place but little credence in what one says 
about the frequency or length of time he had indulged 
(as they all say they have quit now). 

Phimosis or an elongated prepuce often serves as an 
exciting cause, both towards precipitating and perpet- 
uating the habit. The late Dr. S. W. Gross attributed 
the beginning and continuance of masturbation as due 
largely to the redundant foreskin. 

The deleterious effects resulting from masturbation 
are not due to the loss of semen, but to the nervous 
shocks and the local irritation to the sensitive urethra, 
prostate and vesicles, causing a congestion of these latter 
two organs ; and a subsequent disturbance of the cerebro- 
spinal nervous system. While excessive sexual indul- 
gence is depressing to the nervous and physical organism, 
and causes congestion and inflammation of the sexual 
organs, yet it is devoid of the nervous shock that attends 
the unnatural practice, as well as the local irritation 
resulting therefrom. The latter provokes more fre- 
quent repetitions of the act. 

Opportunity, too, also favors frequent indulgence, and 
the sexual organ that suffers most is unquestionably the 
prostate gland. 

Cold weather or wet feet aggravate all abnormal con- 
ditions of the prostate and bladder, and it is often the 
case that one affected with chronic prostatitis is compara- 
tively comfortable through the summer, but begins to 



107 

suffer on the approach of cold weather. Then again one 
may have been conscious of the existence of some form of 
bladder trouble for years, but think it of not sufficient 
gravity to consult a physician, until having gotten his 
feet wet, or been exposed to severe cold weather, when 
an acute attack was precipitated. 

All forms of prostatic diseases are subject to acute 
exacerbations; and violent instrumentation, strong in- 
jections within the deep urethra, large doses of turpen- 
tine or cantharides often provoke an inflamed condition 
of the gland. 

Horseback and bicycle riding are etiological factors of 
no small importance, and especially when the gland is 
already tender or when there are other excitant causes. 
The pressure of the saddle upon the perineum, and the 
jolting of a misstep of the horse, or by a rough road for 
the bicycle, is exerted upon the deep urethra or pros- 
tate. Many men, suffering from prostatitis, have told 
me that they had observed the ill effects of a ride upon 
their wheels. 

Continence. — A knotty problem, that often arises in 
the treatment of diseases of the prostate, relates to the 
effect, that total abstinence from sexual congress, has 
upon the gland of robust persons not in position to nat- 
urally indulge their sexual propensities. As before 
stated, it is a fact, recognized by all leading genito- 
urinary specialists, that the prostate in all healthy men 
normally becomes hyperemic during erotic excitement; 
and it is in accordance with natural laws, that such ex- 
citement occurs at certain intervals, regardless of what- 
ever moral or persuasive influence may be exerted to the 
contrary. While this state may be greatly mollified by 
one's habits, and by surrounding influences to direct 
the mind into channels of chastity and morality, yet the 



108 

intrinsic excitation, as exerted by the sexual organs, in 
performing their normal functions, is transmitted to the 
sexual brain or nerve center, which, in turn, excites 
hyperemia, especially in the prostate gland and penis. 
This local congestion or nervous excitation can be con- 
trolled for a time without injury either to the gland or 
nervous system; but continual recurrences of sexual 
erethism, engendering the accumulation of semen, over- 
distending the vesicles to the extent of causing discom- 
fort, and producing continuous prolonged prostatic 
hyperemia, finally results in congestion, irritation and 
inflammation; and, by reason of the highly sensitive 
nervous organization of the gland, and the reciprocal 
relation it bears to the sympathetic and cerebro-spinal 
nerve centers, various nervous disturbances of the latter 
are produced. 

I have had under my observation several cases of 
chronic priapism and different forms of neurotic aberra- 
tions, evidently due to continence as the prime cause, 
and resulting eventually in chronic prostatitis, and all 
the attending sequels incident to the disturbance of the 
sexual organs, and nervous disorders. 

There are others where the surrounding influences, 
united with lascivious readings, libidinous thoughts and 
the intrinsic excitations of the normal functions of the 
organs, produce chronic sexual and nervous disturb- 
ances at a much earlier date and in a more aggravated 
form. For this reason I have usually much less trouble 
in treating married men than single. 

Age, vocation and physical condition must also be 
taken into consideration. It is not difficult for a man 
past thirty, of delicate physique and whose business 
inyplves mental exertion totally at variance with any 
lascivious impressions, to abstain from sexual relations 



109 

for an indefinite period without injury resulting from 
violating natural laws. But in the case of a young man 
of robust health, whose occupation requires but little 
mental exertion, and whose surroundings and associates 
tend to excite lust, continence would cause much pros- 
tatic irritation, congestion and inflammation. 

Alcoholic stimulants of all kinds tend to produce 
erethism and congestion of the gland and should be 
avoided. Beer and wines have particularly a baneful 
influence. 

SYMPTOMS OF SUB-ACUTE AND CHRONIC PROSTATITIS. 

In most cases the symptoms of sub-acute and chronic 
prostatitis are similar in many respects to those of 
stricture, localized urethritis, vesiculitis, or chronic gon- 
orrhea ; or all these may coexist. In many instances the 
symptoms are apparently not connected with any dis- 
ease of the sexual organs. They are manifested by 
mental depression, lack of confidence, melancholy, im- 
potency, nervous dyspepsia, impaired memory or in- 
somnia. 

The eyes are usually dull, and often become so dis- 
turbed as to necessitate consulting an oculist. 

Dysuria is rare unless complicated with stricture, 
granular urethritis or vesiculitis. In fact the urine 
being normally an aseptic fluid resists the development 
of pathogenic bacteria, although thirty or more varieties 
of non-pathogenic bacteria are often present therein. 

GLEET 

A slight continuous discharge is a prominent symp- 
tom of prostatitis. It unquestionably signifies the 
presence of a pathological lesion in some part of the 
genito-urinary tract. 



110 

The origin and source of this discharge has been the 
subject of much comment and investigation, as well as 
diversity of opinion among genito-urinary specialists. 
The fact that such a discharge does arise from some 
ulcerated, granular or inflamed surface is indisputable; 
and the urethra and prostatic points being the most 
favorable sites for producing such discharge, have suf- 
fered the burden of caustic applications and operative 
procedure. 

Gleet is not a disease per se, but a symptom of an 
existing lesion, and while it is generally understood to 
be a sequel of gonorrhea, yet scant discharges from the 
urethra occur from other causes so closely simulating it, 
that it is difficult to draw a marked line of distinction. 

The writer considers that when a persistent urethral 
discharge, whether due to gonorrhea or to other cause 
and of mild character, resists all ordinary urethral 
treatment, it is symptomatic of chronic prostatitis. Vesi- 
culitis may coexist, and the vesicles should be examined ; 
but as the large majority of cases of vesiculitis originate 
from the urethra, or prostate, whether due to gonorrhea, 
masturbation or other causes, the infection or extension 
of the inflammation must necessarily pass through the 
prostate before reaching the vesicles, and hence must 
involve the former. It is therefore irrefutable that the 
prostate, being in closer proximity to the urethra, and 
owing to its exposed position with regard to the 
bladder, is much more liable to become involved than 
the vesicles ; yet the trouble, if of aggravated form, often 
extends and affects the latter. 

The urethra is still more exposed than even the pros- 
tate, and never escapes disturbance when disease of the 
latter has existed any great length of time ; as the irri- 
tative discharge from the prostate or vesicles passing 



Ill 

out into the urethra — their only source of exit — would 
eventually provoke urethritis; and upon examination, 
one finding a sensitive or inflamed canal, infers that the 
trouble was confined to the latter instead of the prostate. 
In fact, urethritis is often the most prominent symptom. 
It is evident, therefore, that by treating and relieving 
the urethra for the time only, the symptoms would recur, 
and continue to do so until the prostatitis or vesiculitis 
was cured. The patient continues to return and report 
the same "morning drop," or forked stream, as indi- 
cating the gluing together of the lips of the meatus, as 
a result of the drying of the discharge before escaping. 

This chronic discharge has been the bete noire of the 
profession from time immemorial, since they have mostly 
confined their treatment to the urethra, or even should 
they realize its source, their means of reaching it have 
been inadequate. 

The urethra has withstood sounds, injections, cauteries 
and lavages for more than a century, and in many 
instances with some relief, but never been cured. 

The reason is, in almost every instance, that the 
source of the discharge is either from the prostate, blad- 
der, or seminal vesicles, and (not infrequently) from 
the pelvis of the kidney; when the latter is the source 
it is the forerunner of true parenchymatous inflamma- 
tion of the kidney itself. 

The objective symptoms reveal a red and often con- 
tracted meatus, the lips of which are frequently glued 
together by the desiccated gleety discharge. Upon pass- 
ing a bougie a boule the first tender point encountered 
is usually about six inches down the urethra, at the 
juncture of the pendulous with the membranous portion. 
Here there often exists an erosion, granular surface or 
probably a stricture. Should one of the former exist, 



112 

without a stricture, the instrument may be arrested 
thereat, by the contraction of the muscular fibers, or 
external sphincter, due to local irritation, induced by 
the contact of the instrument with the sensitive point. 
The membranous part of the canal is quite tender, and 
the most favorable site for stricture, excepting that part 
near the meatus. On reaching the prostatic portion of 
the urethra the instrument detects the most sensitive 
part of the canal, which imparts the feeling of rough- 
ness, indicating a granular surface over which the in- 
strument is passing. Just as we regard the tongue as 
an index to the condition of the stomach, so in like man- 
ner do I consider the prostatic urethra symptomatic of 
the state of the prostate or vesicles. The instrument, if 
small, often enters the utricle and becomes arrested. 
This should be especially guarded against, as it often 
causes one to mistake the case for one of stricture, or if 
any force be used it may result in a false passage being 
formed. Should the prostatic urethra be excessively 
sensitive the bougie may not pass on account of spasm ; 
this condition, too, may be mistaken for stricture or en- 
larged prostate; but it must be remembered that an or> 
ganic stricture never occurs in the prostatic portion of 
the canal. 

At times, when the urine is acrid, there is some diffi- 
culty in thoroughly evacuating the bladder. The irrita- 
tive effect of the urine upon the tender part of the canal 
causes a contraction of the circular muscular fibers of 
the urethra at that point, which subsequently relax and 
allow the passage of a few drops or a drachm of urine 
thereafter. Some have slight pain just as the urine 
starts, others at the close or urination, which is often 
attended with the sensation of there being still more to 
pass* 



113 

By means of a flexible bougie a boule, passed slowly 
along the urethra, the most inexperienced physician can 
readily detect any stricture or rough, tender patches 
that may exist therein. Every general practitioner 
should therefore supply himself with three sizes of these 
bulbous bougies — Nos. 12, 14 and 16, Am. 

The most accurate way of detecting the real character 
of localized lesions within the urethra and bladder, as 
well as the condition of the prostate and its ducts, is by 
means of the writer's improved cystoscope, which can 
be introduced much more easily and with less pain than 
any other instrument on the market. 

The author's instrument uses the direct light; this is 
much more accurate in locating lesions than those which 
are constructed upon the principle of reflected light, 
which latter are made and used mostly in Europe. It 
requires skill as well as much experience to successfully 
use these instruments. They should never be used when 
the prostatic urethra is so inflamed that it bleeds freely 
when the instrument is introduced, whether it is exces- 
sively tender or not ; as a drop of blood will so obstruct 
the light from the mirror as to prevent one seeing the 
condition of the lesions. The localized inflammation of 
the prostatic urethra should always be allayed before 
this instrument is used. "When this has been accom- 
plished by means of the ointment which the writer has 
perfected for this special purpose, then my improved 
instrument can be introduced with impunity, and the 
conditions of the lesion as well as of the abnormal gland 
and bladder can be easily ascertained, without guessing at 
the morbid condition or at its location. Besides, by this 
means, medicaments can be applied directly to the sore. 

The improved instrument devised by the author is 
made in two sizes, 26 F. and 22 F. The former gives 



114 

the more satisfactory view and should always be used 
when the calibre of the urethra permits it. 

The instrument should be carefully examined, ren- 
dered aseptic, and the light tested before it is introduced. 
In some few cases the urethra is so callous to instru- 
mentation that it is unnecessary to use an anesthetic, but 
where it is unduly sensitive I always use cocaine locally, 
by means of my special applicator, as it is unpardonable 
to subject one to pain when it can be so easily and harm- 
lessly avoided. For this purpose I use from three to 
ten per cent, strength of cocaine, dependent upon the 
degree of sensitiveness of the urethra. In practically 
all cases the prostatic portion of the canal is the most 
sensitive, and the greater amount of the cocaine should 
be applied thereto. By means of my specially con- 
structed instrument described in the supplementary 
work on Treatment, medicine can be applied to any por- 
tion of the urethra or neck of the bladder as desired, and, 
by exercising any degree of caution, with impunity. The 
cocaine is drawn into the instrument by means of the 
bulb at the upper extremity, similar to that of a medi- 
cine dropper, and is pressed out in the same manner. 
If the upper portion of the canal is not tender, or but 
slightly so, I do not press the bulb until the instrument 
reaches the prostatic portion, when slight pressure is 
made, but not sufficiently to force out the entire amount 
of the fluid. The bulb is then allowed to expand, when 
the surplus of the liquid is again taken up. After wait- 
ing a minute or so the bulb is again pressed slightly as 
before. This is continued several times before the entire 
amount is ejected. Should the pendulous urethra be 
sensitive, the cocaine can be applied along its entire 
length in the same way as before described. I use a 
bulb on my instrument that only holds twenty or thirty 



115 




Figure XV. 

minims, so that a ten per cent, strength of cocaine can 
be used with impunity and the parts thoroughly anes- 
thetized, whereas, by an ordinary syringe, which is gen- 
erally used, it would be dangerous. 

Figure XV illustrates a case where a local irritation 
and discharge continued for many months. By means 



116 

of the cystoscope an ulcer was located in the fundus of 
the bladder, opposite the seminal vesicles, which had 
caused the symptoms puzzling to the writer for many 
months previous. 

Figure XVI gives a practical illustration of the cysto- 
scope as used by the author to determine the exact state 
of the prostate and neck of the bladder, without having 
to resort to guess work. 

Much discussion has been carried on during the past 
two decades, and more especially during the last decade, 
concerning the diagnostic value of the cystoscope. Some 
years ago a question was put to the leading genito- 
urinary physicians in the United States regarding the 
extent of their use of the cystoscope in diagnosis and 
its value therein. The replies elicited the fact that the 
consensus of opinion among them was that the instru- 
ment was of small value in the diagnosis of disease ; and 
the majority of physicians asserted that they seldom or 
never used it. 

The chief reason of the disapproval of the use of the 
cystoscope by most of these physicians arose from the 
fact that it is difficult to introduce, and the difficulty of 
maintaining the light sufficiently long to obtain a cor- 
rect view of the parts is great. Most of these instru- 
ments are so rough at the juncture of the obturator, 
the electric light, the curve, and the opening through 
which to view the parts, that its use is attended with 
much pain and hemorrhage — thereby obstructing the 
vision by the blood getting on the glass window. It is 
absolutely necessary for the blood to be controlled in 
order to use this instrument successfully. Instruments, 
mostly of foreign manufacture, are in use ; where the 
light is reflected from the distal end of the instrument, 
instead of having a direct light as illustrated in Figure 



117 




Figure XVI. 



118 

XVI. The author finds this latter instrument of ines- 
timable value, not only in diagnosing the different con- 
ditions at the time of examination, but in ascertaining 
the conditions as the treatment progresses, or obstinacy 
of the ulcer remains. By this observation one can deter- 
mine when the conditions require specific remedies in 
order to effect an improvement or cure. 

Some times there are small ulcers located within the 
neck of the bladder or prostate that cannot be detected 
except by the cystoscope. In one case that resisted treat- 
ment for many months, apparently the prostate, vesical 
neck, urethra and adjacent organs were entirely well. 
Yet there continued symptoms to indicate by way of a 
discharge, and at times pain, that there was still 
some lurking lesion. By inflating the bladder to its full 
extent, with the use of my improved cystoscope I 
detected a small ulcer as shown behind the prostate and 
opposite the seminal vesicles in Figure XV. The sem- 
inal vesicles had been involved, but were now cured. 
This ulcer evidently had given rise to the ulceration in 
that region. Many other examinations have demon- 
strated, that often when the seminal vesicles have been 
inflamed any length of time, that ulceration of the 
bladder at this point often ensues. 

The instrument is also of great value in determining 
differential diagnosis of true hypertrophy, or glandular 
enlargement, resulting from ulcer or other causes. It is 
also of value in ascertaining the amount of inflammation 
of the bladder, often present in long standing cases, 
where the inflammation extends over one-third, one-half, 
or even more of the bladder. 



119 




Figure XVII. 



120 

Figure XVII illustrates the use of an instrument 
devised by the author, which is of the greatest impor- 
tance in the treating and diagnosing of any ulcerated 
surface along the urethral canal from the meatus to the 
neck of the bladder, and in the prostate. It is of special 
value to any one not skilled in the use of the cystoscope. 
By means of this instrument, one can easily detect, by 
placing cotton on the end of a stick (as illustrated) 
whether any ulceration or abraded surface exists in the 
urethra. The cotton is to be withdrawn occasionally 
at different distances in the canal, for examination, but 
more especially after it has reached the prostatic urethra 
or the vesical neck. The advantage of this instrument 
over the cystoscope consists in its being smaller; it can 
therefore be introduced much more easily and with less 
pain. Again, after an ulcer is located, medicines can be 
applied with the other end of the stick (to which cotton 
is also attached) direct to the ulcer. By withdrawing 
the instrument half inch to one inch, with a fresh piece 
of cotton attached to another stick the superfluous medi- 
cine can be absorbed. By doing this any of the medica- 
ment which may have become attached to the instrument 
may be removed, and smearing of the entire urethral 
canal on withdrawal may be avoided. This is a very 
important point, and will be elaborated upon in the sup- 
plementary volume. It does not really belong to the 
present volume, but I have taken the precaution to thus 
give timely warning to any one who might make the 
attempt to treat cases with this instrument before getting 
full instructions regarding it. 

I also use a proctoscope or sigmoidoscope, which is 
constructed upon the same general principle as that of 
my cystoscope. This is a very useful instrument in de- 
tecting the condition of the prostate, vesicles, and rectal 



121 

mucosa through the rectum. Before having procured 
this instrument I was in great measure groping in the 
dark with reference to the diagnosis as to the real con- 
dition of the vesicles, perivesiculitis and the rectal mu- 
cosa around the prostate. 

I have found the best way to use the instrument is to 
pass it gently into the rectum and up to the sigmoid flex- 
ure ; the obturator is then removed and the eye piece, or 
metal plug, is inserted, together with the air bulb. Gen- 
tle pressure of the latter distends the rectum around the 
vesicles, and also prevents the fecal matter from drop- 
ping down within the tube. Mild distention of the 
rectum with air discloses the condition of the vesicles 
and surrounding tissues perfectly. The tube is slowly 
withdrawn and at the same time continuing the air 
pressure when the condition of the entire rectum and 
prostate can be accurately noted. 

The pressure of the air should not be too great or it 
will cause over-distention of the colon and result in 
colicky pains. 

The voltage necessary for lighting these endoscopes 
can be obtained from cell batteries, provided they are 
supplied with suitable rheostats. The objection to cell 
batteries, however, is that the cells deteriorate with use, 
causing, when much used, irregular current or voltage. 

I prefer the current from the direct incandescent cir- 
cuit, with a properly constructed controller, when the 
voltage is uniform, whether used five minutes or all day 
long. 

NOCTURNAL EMISSIONS. 

Nocturnal emissions are not infrequent with unmar- 
ried men, and especially when granular prostatic ureth- 
ritis coexists with inflammation of the gland. Such 



122 

lesion of the urethra inhibits its normal elasticity, which, 
as a result, can not be accommodated to the elongated 
penis when erect, and produces an undue drawing upon 
that part of the tender canal that causes a fortuitous 
seminal discharge. One emission often irritates the 
prostate or vesicles and thereby causes a second or third 
on successive nights, and occasionally two in one night. 

In other cases there is a condition of atony, and a 
relaxed state of the ejaculatory ducts and gland, when 
an emission may take place without creating sufficient 
sensation to arouse one from sleep. Again, these organs 
may be so sensitive, by reason of these lesions, that in 
an effort at sexual congress there is a premature ejec- 
tion; at times, this may occur before intromission. 

There is frequently a prostatic discharge, that is 
erroneously taken to be of a seminal character. These 
chronic discharges, from whatever source they may 
arise, rarely cause noticeable systemic disturbances, 
unless they are very excessive. The pathogenic change 
in the prostate or vesicles, excites or depresses the 
nervous system, and so disturbs digestion and prevents 
in many instances proper assimilation. Often there is 
little or no systemic disturbance, and one may remain in 
apparent robust health for a long time, yet he is con- 
scious of something being wrong with his sexual organs. 
There are others whose general health is very much im- 
paired as a result of disorders of these organs, yet have 
few subjective symptoms pointing directly thereto. 

DIAGNOSIS. 

The diseases for which chronic prostatitis is most liable 
to be mistaken, are stricture and localized urethritis. 
The latter two may either succeed, coexist with, or be 
excitant causes, of the former. 



123 

The prostatic urethra is the most common site of 
urethritis and is pathognomonic of prostatitis. As or- 
ganic stricture never occurs in the prostatic urethra, one 
familiar with passing a bulbous bougie can easily deter- 
mine when it has passed the membranous and entered 
the prostatic portion of the canal. This can also be 
determined by the length of the channel and the distance 
traversed by the bougie. Or, the operator may pass the 
bougie into the bladder, and, by withdrawing it, measure 
the distance and locate the points where it meets with 
resistance or roughness at the entrance of the prostatic 
urethra. There is also, at the point of roughness, a slight 
sensation of pain or irritation, which may not be felt at 
any other portion of the canal, or if at all, but faintly. 

Owing to the granulated and slightly swollen condition 
of the prostatic urethra, it encroaches to some extent 
upon the calibre of the canal, causing some narrowness. 
This condition may be mistaken for stricture. Further- 
more, the channel being sensitive at an inflamed point, 
the contact of the instrument with the mucous mem- 
brane thereat may produce reflex contraction of the cir- 
cular muscular fibers simulating stricture. This causes 
either a grasping of the instrument or obstructs its 
passage for the time. As previously stated, if an instru- 
ment of small size is used it may enter the orifices of 
the ejaculatory ducts or utricle (as they are frequently 
dilated in these diseases) and becoming arrested thereby, 
create the impression that stricture exists. I have known 
such mistakes made and urethrotomy performed there- 
for. 

The first morbific change that occurs within the pros- 
tate, is chronic catarrhal folliculitis. This condition may 
last for years, under strict observance of hygienic laws 
and temperate habits with little or no manifest symptom 



124 

than that of an occasional or persistent gleety discharge ; 
or the discharge may be so faint as to become dessicated 
after reaching the urethra, and noted by shreds in the 
first voiding of urine. Subsequently the inflammatory 
conditions extend to the interior of the gland and pro- 
voke interstitial prostatitis, causing soft infiltration with 
slight tumefaction of this organ ; yet, there may be little 
or no local or systemic disturbance, unless there occurs 
an abrasion of tissue within the prostate, when the 
toxins or cocci may become absorbed and engender 
metastasis. 

It is quite common for some men, influenced by these 
toxins, to become emaciated and delicate, though suffer- 
ing no pain or marked constitutional disturbance, while 
others remain robust in appearance, though suffering 
from metastasis, or pains anywhere from the back of 
their neck to their heels. Others become nervous from 
functional involvement of the cerebro-spinal centers, 
causing melancholia, impaired memory, sciatica, para- 
paresis and many other forms of nervous disturbances. 
These changes may develop so insidiously as to create no 
uneasiness upon the part of the victim, unless the vesicles 
become involved, or the inflammatory conditions en- 
croach upon the ejaculatory ducts, narrowing their 
calibre or limiting their normal elasticity to the extent 
of obstructing the passage of semen altogether; or, 
should the semen pass through these narrow channels, 
during sexual congress, it would be followed by dull 
aching pain, or marked nervous depression. 

Dull aching pain in the perineum after sexual con- 
gress indicates that the ejaculatory duct is greatly nar- 
rowed as well as inflamed. It also is a positive symptom 
of an inflammatory condition of this gland. Should this 
pain or aching sensation be only temporary and pass 



125 

off within thirty or sixty minutes, the indications are 
that the disease does not extend to the seminal vesicles ; 
but should it be followed by a dull aching pain in the 
back or perineum for any great length of time, it indi- 
cates that the seminal vesicles are also affected. Condi- 
tions are then much more serious than where the gland 
alone is involved. 

The instruments and remedies I have devised for treat- 
ment of the seminal vesicles through the rectum are the 
only possible means of reaching and curing these 
troubles. But even with them it requires time and 
patience from both physician and the sufferer. I cannot 
impress this too forcibly on the minds of my readers, 
as heretofore physicians have never been able to trace 
the source of this pain and trouble, with its attendant 
nervous complications. 

Long standing disease of the gland develops a con- 
gested state and inflammatory complications of the 
bladder, rectum, vesicles, and, at times, the kidneys, but 
the latter are rarely affected to any serious extent. 

TREATMENT. 

For many years past I have been endeavoring to train 
my assistants in such a way that they could act inde- 
pendently in properly carrying out* my methods. I 
must confess that so far I have been disappointed with 
the results. The men in question, when left to their 
own resources, were never absolutely sure that the treat- 
ment they were giving in any particular instance, was 
absolutely correct. Although one of these assistants 
had been associated with me at different times for more 
than three years, at the end of this period he constantly 
failed in his efforts with the cystoscope ; so much so 
indeed that he could not be induced under any circum- 



126 

stances to use the instrument except under the personal 
supervision of the writer. Two others had become so 
averse to using it, that they would not do so if they 
could possibly avoid it. As they expressed it, "they 
noticed a marked difference in the use of this particular 
instrument when the writer used it and when they them- 
selves used it." A fourth was so egotistical and self- 
opinionated that he insisted upon using it upon each 
and every occasion; this regardless of the crude bung- 
ling manner he was manipulating it — besides, he often 
used it in cases where it was actually specially contra- 
indicated. When not restrained by the writer he suc- 
ceeded in giving rise to serious and dangerous troubles 
in several patients, and probably caused the death of one 
man. At the time this took place the writer was absent 
on his annual vacation ; he received reports twice a week 
from the assistant stating that all the patients were 
doing well, were highly pleased, and progressing satis- 
factorily. On his return the writer was mortified to 
learn that there was scarcely one patient but what the 
assistant had "balled up," to use the term applied by 
the family physician to one of the patients. Of course 
the assistant was promptly discharged, — yet he is now 
in another city applying these methods in his same old 
clumsy way, and boasting that he had been specially 
instructed by the writer in the use of them. 

I do not wish to convey the idea that the writer alone 
is capable of using these instruments and methods judi- 
ciously and satisfactorily, as there are some physicians 
to whom he has shown the technique of his special instru- 
ments and methods who are now using the same with 
excellent results. One of these stated to the writer that 
since he had had the methods practically demonstrated 
to Jiim, he could now understand why he had failed 



127 

before. Previously he would often pass the instrument 
within the baldder, and apply his medicament at a point 
beyond the sore. At other times he would stop the 
instrument and apply the remedy before reaching the 
sore. The greatest difficulty he encountered in the pass- 
ing of these instruments, was to determine whether an 
obstruction met with was stricture, enlarged prostate, 
or caused by a spasm of the canal; or whether his lack 
of experience led him to make the curve at an improper 
time. Although he studied my book as well as others 
by various authors very carefully, yet they did not give 
him the knowledge that a personal demonstration of the 
technique of the instrument did give. Since then numer- 
ous letters have been received by the writer detailing 
this physician's marked success in the treatment of these 
cases. Of all the cases that he has handled only two 
were so complicated that he was necessitated to procure 
my assistance before curing them. 

I have received numerous letters from physicians 
throughout the United States as well as Europe — many 
asking for advice, while others relate their "ups and 
downs," and failures, mostly bemoaning their fate of 
not being able to procure the same results as the writer ; 
many detailing, too, their methods of treatment, and 
invariably harping upon the unsatisfactory results they 
procure from electricity. Practically all of them who 
have described their methods of treatment have reiter- 
ated the fact that they have used electricity with my 
instruments ; and almost without an exception they have 
rendered the patient so tender, as often to set up cystitis, 
orchitis, and prostatitis, and to confine the patient to bed 
for weeks. I cannot understand the reason, unless prac- 
tically all of them are hunting the "short cut" instead 
of taking time to cure their patients properly. Some of 



128 

their patients who finally came to me, stated that these 
physicians had been treating them by the same methods 
for six, eight or even fifteen or eighteen months without 
any improvement; others claim that they had been im- 
proved up to a certain point only. If these physicians 
had consulted my last edition, issued seven years ago, 
they would have read: "As the urethra and rectum 
are the only channels through which to reach the pros- 
tate for direct treatment these must be rendered and 
maintained in a condition as free from inflammation or 
irritation as possible. As the larger portion of the pros- 
tate lies between and in contact with these two canals 
it would be impossible to relieve the gland as long as 
they remained inflamed." 

This is followed by directions to allay all acute irri- 
tation as much as possible before beginning radical treat- 
ment of the gland. On a succeeding page there follows : 
* ' Radical treatment of the gland should be delayed until 
all acute symptoms of the urethra are allayed." They 
disregard the frequent expressions throughout the book 
forbidding the use of electricity until all acute symp- 
toms have been allayed. Even then, I use it very rarely 
and only for a specific purpose, as will hereafter be 
detailed; but the strange thing seems to be that each 
and all of these correspondents (judging from their let- 
ters) consider that electricity is practically the only 
remedy and must be used at all times. 

There have been, however, a few physicians, who, even 
with the crude and imperfect instruments of a few years 
back had procured satisfactory results up to a certain 
point. In several instances of this kind that have come 
to the notice of the writer, it has developed that the 
physician has succeeded in curing the ulcers at the neck 
of the bladder and within the prostate. Further prog- 



129 

ress was rendered impossible because of the fact that 
complications were present, such as vesiculitis, sigmoidi- 
tis, etc. These had been overlooked by the physician. 
Their presence maintained the irritation within the 
gland and bladder — as soon as they were cured, com- 
plete restoration to health ensued. 

The writer has endeavored to so thoroughly explain 
the physical, the chemic, electrolytic, cataphoretic and 
therapeutic properties of the currents in the introduc- 
tory chapter as to enable one to determine absolutely 
when to use the current and when not to use it. 

In all of my writings I have endeavored to impress 
as forcibly as lay in my power that it was utterly im- 
possible to cure any disease of the prostate, seminal 
vesicles, bladder, or even pelvis of the kidney, without 
at first allaying all acute symptoms, within both the 
urethra and rectum. 

Because of the diversity of symptoms, both subjective 
and objective, and the many complications arising from 
the different lesions; the obstacles to be overcome in 
diagnosing and treating the various conditions that arise 
as sequelae ; the extreme difficulty the writer has expe- 
rienced with different practitioners in their efforts to 
successfully cope with these cases; the many points to 
be determined with reference to the use of instruments 
and the application of special remedies in the different 
stages of diseases; and in order also to more thoroughly 
assist his readers in locating the different lesions and in 
observing the complications, and then to enumerate the 
obstacles met with in treating abnormal conditions 
(many of them being in deep seated organs far remote 
from the surface) ; for these reasons the writer has 
decided to incorporate such matters in a supplementary 
volume, in which he can make more extended illustra- 



130 

tions of the lesions, their locations, and how to reach 
them; descriptions of his special instruments; and how 
to apply each and every remedy in the different stages 
of the various diseases he has outlined for treatment. 
So full and explicit will be the directions given that any 
practitioner should be able to satisfactorily use his 
methods. 

One of the great difficulties to be overcome (which 
practically every practitioner encounters) is to differ- 
entiate between acute, sub-acute, and chronic diseases; 
and to use remedies suitable for each condition, rather 
than cause much harm by using a remedy which is 
intended for a different stage, thereby increasing the 
acute inflammation, and often subjecting the patient to 
intense suffering and long delayed recovery. 

There are a great many men suffering from the 
diseases dealt with in this work in every locality; and 
it is essential that all physicians should be able to diag- 
nose these cases correctly, rather than be misled into 
other topical or constitutional treatment. This does not 
justify each and every physician equipping himself with 
the various instruments and remedies mentioned in this 
work, and to apply himself especially to this treatment. 
There would not be enough cases in any district to 
justify all the physicians in the neighborhood devoting 
time, attention, and money to any one particular branch 
of medical practice. But there are sufficient cases of 
diseases such as are dealt with in this volume in each 
and every locality for at least one physician to thor- 
oughly equip himself and to thoroughly master the sub- 
ject — and he will have all the business he can possibly 
attend to. 

While it is a fact that there are physicians who are 
devoid of the mechanical skill necessary to successfully 



131 

introduce or apply instruments, and who never could 
make an unqualified success of this treatment, yet there 
are others in every locality who could make a success 
of it; and these latter should so apply themselves to it, 
and abandon all general practice (thereby being out of 
competition with general practitioners) as to command 
the respect of their fellow practitioners by their skill in 
this particular specialty. 

To Briefly Summarize. — For one to thoroughly ap- 
preciate the advancements made by the writer, and to 
fully derive benefit therefrom, he should read carefully 
every sentence in this book from the beginning of the 
preface, through the introductory, and through each 
succeeding chapter. There are many things of impor- 
tance in all these different parts; and should the reader 
skip here and there (as many do in reading a book), he 
loses the connection and is never enabled to do the work 
properly. There are important features in the preface 
that lead to the elucidation of subsequent discussions and 
by missing one link in the chain of reasoning the subject 
matter never becomes clear ; and the reader is unable to 
carry out in detail the train of thought leading up to the 
cause, diagnosis, and ultimately the treatment. 

The great majority of physicians, as well as other men 
in every line of business and profession, want to take 
"short cuts" to success. Physicians simply "jump at" 
the treatment, without reading a word of the instruc- 
tions relating to the causes, the conditions of different 
patients, and the different stages of disease, each of 
which must be treated in a separate and distinct man- 
ner. Most physicians are apt when seeking for a "short 
cut" in a chronic disease, to give remedies which are 
appropriate in acute stages only, and vice versa. This 
in part accounts for the failures of physicians, and is 



132 

the reason they cannot procure the same results as the 
writer. This reason more than any other has decided 
me to first write a treatise upon cause, effect, and diag- 
nosis before writing the supplementary treatise on treat- 
ment of these troubles. Those procuring the present 
volume will be necessitated to read it understandingly 
before they can decide whether or not they want the 
supplementary volume on treatment. 

The author will make the broad statement that he is 
prepared to demonstrate with any reasonable number 
of cases of any age from one year to eighty-five that he 
will cure from 70 per cent, to 95 per cent, of any and 
all chronic diseases, including prostatic, kidney, heart, 
lung, nervous diseases, etc. In making this broad and 
bold statement, the writer maintains ample margin in 
his favor in each and every class of disease, and his con- 
fidence is warranted by results which have been obtained 
for more than a decade, and in many thousands of cases. 
Then, too, he feels and realizes that now he has also 
the advantages in his favor of the recent improvements, 
and advancements, and more perfect instruments, that 
enable him to do more at this date than he has ever been 
able to do in the past. 

He, of course, does not include cases that have been 
maimed by operations, or where organs have been re- 
moved, but he does not exclude any case on account of 
age or condition. The writer will further emphasize 
the foregoing statement by stating that his methods are 
fully elucidated, and based upon physiologic, chemic, 
physical, and therapeutic laws of nature that are 
known to many scientists throughout the world. He 
does not employ some mystic serum from some cold- 
blooded animal, or from other source equally as depress- 
ing, which is capable of contaminating the blood and 



133 

tissues of the victims with more virulent toxic matter 
than is produced by or causes abnormal condition itself. 
The administration of many of these serums may (if 
they have any effect at all aside from that of toxic) 
result in abscesses, from the efforts of nature to rid the 
system of them ; and they serve to lower vital action and 
render the unfortunate less able to withstand the rav- 
ages of the disease, and ultimately bring about an un- 
timely death. I only beg of those who wish to profit 
by my results as herein detailed, to thoroughly read this 
book, and if they are satisfied to take up the subject in 
earnest and profit from the results of my investigations, 
then they can procure the supplementary work. The 
writer in beginning this present work had many "ups 
and downs ' ' and many disappointments, and was often so 
discouraged as to give the work up at different times, only 
to go back to it with a greater determination to succeed. 
The past two years has marked a new era in the prac- 
tice of both medicine and surgery. Although isolated 
cases of disease of the heart, spine, brain and various 
others of obscure origin had for a long time been de- 
tected and relieved, yet within the past year the writer 
has been so enabled to trace cause and effect from 
special lesions which disturb certain sympathetic gan- 
glia (giving rise to functional disturbances, and often 
organic lesion of the heart, brain, spinal cord and other 
deep-seated vital organs), that he now undertakes the 
diagnosis and ultimate cure of the majority of these 
diseases with the confidence with which he formerly 
undertook the solution of a mathematical problem. 

. CHRONIC PROSTATITIS AND PROSTATIC URETHRITIS. 

Case 3. Aged twenty-four; single; history, as given 
by himself, is as follows : When eighteen he had gonor- 



134 

rhea which lasted about nine months. During the first 
stages of the disease dysuria was excessive, the dis- 
charge from the urethra being very copious, and followed 
by vesical tenesmus, chordee, etc. He had several suc- 
ceeding attacks, which lasted only a few weeks, during 
which time there was but little pain or disturbance of 
any character. A gleety discharge followed, continuing 
up to his twenty-first year, when he was pronounced 
strictured, and treated for such by means of steel sounds. 
The treatment was very painful and at first followed by 
bloody discharges. This continued for about a year, 
during which time there was a continuous gleety dis- 
charge. His health was much impaired ; there was a dull 
aching sensation in the region of the perineum, espe- 
cially when walking or standing. He changed physi- 
cians; sounds were used as before, but larger, and pro- 
ducing hemorrhage attended with great pain. His health 
continued to grow worse ; he became very thin ; suffered 
with anorexia, emissions and weakness of the sexual 
organs, dull headache, despondency and lack of confi- 
dence. 

Upon examination I found the meatus red, inflamed, 
and the lips glued together. There was a granular ulcer 
in the fossa navicularis about an inch behind the glans 
penis. On the introduction of a bougie a boule, there 
was little sensitiveness of the urethra until the prostatic 
portion was reached, where roughness offered a slight 
resistance to the passage of the instrument, indicating 
a granular ulceration, and extreme tenderness. On with- 
drawal of the instrument pus and mucus were found 
adhering to it. Microscopical examination did not reveal 
any gonococci. Upon pressure through the rectum 
there was very slight tenderness of the gland and little 
or no swelling. 



135 

Cystoseopic examination revealed extensive ulceration 
throughout the bladder for a man of his age. 

This case was long drawn out, with recurrences of, 
sometimes, better condition, then worse. Finally he was 
dismissed in practically a normal condition. This case 
was under observation for several years after dismissal, 
and there was never any symptoms of the trouble 
recurring. 

In consideration of the marked improvement in instru- 
ments for use in the various obstinate and chronic 
diseases of deep-seated organs, and the recently discov- 
ered remedial agents used in connection therewith, the 
writer has decided to incorporate in a supplementary 
volume a full and lucid description of both remedies and 
instruments. By so doing he is thoroughly convinced 
that any intelligent physician who has been impressed 
favorably with this method of treatment, and who is 
determined to succeed in it, can accomplish results that 
cannot be obtained by any other methods. 

The results obtained of late by others with these reme- 
dies, convinces the writer that much more decided and 
satisfactory results can be obtained by means of his im- 
proved remedies and instruments than could ever have 
been obtained before. 

A physician in a distant town wrote me stating that 
he had a man 62 years of age, suffering with enlarged 
prostate, diabetes, and passing three to four quarts 
daily, necessitating a continuous use of the catheter. 
The introduction of the catheter was frequently at- 
tended with hemorrhage. It was impossible for the 
man to come to Chicago for treatment; he therefore 
begged of me to send him any kind of advice or remedy 
that might help the patient. 

I wrote him that he was asking too much, and that 



136 

the case would be difficult for me to relieve or help 
materially if he were even here in person; but under 
the circumstances I said "I shall send you a certain 
remedy for local application as I shall direct; and 
another remedy to be taken internally for a specific 
purpose, also an instrument to be used as I may advise. ' ' 
Three weeks thereafter the doctor wrote me, "Our 
patient has improved wonderfully. He has laid aside 
the catheter altogether ; his diabetes has diminished more 
than half ; and he has gained strength, and is improving 
daily." So encouraged was I with this and many other 
similar reports, that since that time I have advised other 
physicians and laymen to use similar remedies in similar 
circumstances. In every instance except one the results 
have been satisfactory. One of these cases reported thus : 
' ' I believe it is only a matter of time and patience when 
I will be entirely cured. I am at present feeling better 
than at any time within the last twenty-five years." 

Until recently I have been very reluctant to allow 
either my special remedies or instruments to be used by 
patients themselves, or by practising physicians who had 
not received special instructions in the technique of the 
methods — but during the past two years I have so im- 
proved remedies and instruments, that I am now confi- 
dent that any intelligent physician, or (in some cases) 
laymen, may derive much benefit therefrom, apart from 
any personal instruction. 

Although the above cases have so improved, and are 
so encouraged as to believe they will be permanently 
cured, yet there are some of them so complicated with 
disorders of the adjacent organs that it requires skilled 
treatment, either by the writer himself or by a physician 
who has been specially instructed either through the 
book, or who has taken special clinical instructions on 



137 

the technique of the instruments and remedies such as 
the writer himself uses in individual cases. 

PROSTATITIS, STRICTURE, VESICULITIS. 

Case 4. Gonorrhoeal history of seven years stand- 
ing, with frequent recurrences; gleet constant. Patient 
had stricture in the membranous urethra, six and one- 
half inches from the meatus — caliber 12 A. Immedi- 
ately back of the stricture and extending through the 
prostatic urethra was a granulated ulcer. There was 
apparently no obstruction to the flow of urine nor pain 
during the time, but at the close of the act there would 
be slight pain and dribbling of urine, lasting from three 
to five minutes. At times a milky discharge preceded 
the flow. This preyed upon his mind, as he believed it 
was spermatorrhea, for which, as he said, ' ' he had taken 
barrels of medicines.' ' He was troubled with sexual 
hyperesthesia, insomnia and hypochondriasis. The dis- 
charge proved to be a perverted prostatic secretion con- 
taining also mucus and pus cells. He was in good flesh, 
though pale and easily tired upon exertion. Sexual rela- 
tions were very erratic. At times several weeks would 
pass without the least desire or even erection. Then 
again there would be an almost insatiable propensity, 
but in attempting the act ejection would occur before 
intromission, followed by a dull aching in the region 
of the perineum. 

Examination per rectum disclosed the seminal vesicles 
exceedingly sensitive and painful upon pressure. The 
prostate also was painful when examined in the same 
way. The pain felt after sexual congress implied one 
of the following conditions : 

(1) the prostate is inflamed, and the ejaculatory 
ducts also ; 



138 

(2) the vesicles are also inflamed as a result of exten- 
sion or inflammation through the ejaculatory ducts to 
them. 

"When the pain is of short duration it is pathogno- 
monic of inflammation of the prostate only, and of the 
ejaculatory ducts as they pass through the gland. If 
the pain is of long duration, and the aching sensation 
lasts several hours, and is attended by an aching sen- 
sation in the back, it specifically indicates that the 
seminal vesicles are involved, and that the pressure 
exerted by these vesicles to force the semen through the 
narrow channels is attended with the symptoms named. 

This case was under treatment for several months 
before the vesicles were entirely relieved; after which 
the man had no further pain during sexual congress. 

In another case, very similar to the foregoing, the 
patient was 68 years of age, and had had gonorrhea sev- 
eral times, resulting in chronic glandular enlargement 
of the prostate. 

After intercourse, or even during intercourse, this 
pain resulting from the inflammation of the vesicles and 
prostate was so excessive that it was attended with reflex 
irritation that so affected his heart as to make him drop 
off the woman and become unconscious sometimes for 
several hours. The man finally died after one of these 
acts. He was advised to avoid sexual intercourse until 
he had been relieved of this condition of the vesicles, 
but he replied that he would rather be dead than to 
forego the pleasure. 

A young man, 35 years of age, had a very similar thing 
occur to him; but this would not be after each sexual 
condition, but only occasionally. 

Case 5. Single ; aged thirty-four ; consulted me for 
"nervousness." He had been a very successful business 



139 

man, having charge of a large force of men in an exten- 
sive establishment. He was naturally very reticent with 
men and timid with women. 

He had never had any venereal disease, and in fact 
had no subjective symptoms of sufficient importance to 
justify an examination of the genital organs. Thinking 
that close attention to business and long sustained taxa- 
tion of his mental powers had given rise to the disturb- 
ance of which he complained, I advised complete rest, 
at the same time giving him a tonic, as he was somewhat 
anemic, though in good flesh. He left my office in good 
spirits, intending to spend a month or two in the Cum- 
berland Mountains, fishing and hunting. In about ten 
days, to my surprise, he returned, saying that he be- 
lieved, had he remained up there a week longer, he would 
have gone crazy; that, while he was away, he did not 
think he had averaged two hours' sleep in the twenty- 
four, and having nothing to do but to think of himself 
and his condition made him worse than when at work. 
The objective symptoms, as revealed by an examination, 
showed an excessively hyperesthetic urethra, so much 
so that the introduction of a soft bougie caused him to 
partially swoon and break out into profuse perspiration. 
He was allowed to remain upon the table, in recumbent 
position, for half an hour, when he fully recovered, say- 
ing that the instrument did not pain him very much, 
but that it caused a peculiar, indescribable sensation that 
rushed to his head and caused blindness. The night fol- 
lowing he had the best sleep that he had experienced for 
six months. I had him use a sedative for seven days 
to allay hyperesthetic conditions of the urethra before 
proceeding further with the examination. 

Upon questioning him further upon the subject, I was 
able to elicit from him the fact that in his early youth 



140 

he had practiced masturbation to a very limited extent, 
but had not done so for fifteen years prior hereto. He 
also admitted that he had attempted intercourse twice 
only in his life and had made such an utter failure, and 
was so disgusted with himself, that he had never had 
sufficient confidence to make a third effort. He had 
noticed a milky discharge at times just preceding the 
passage of urine, and also when at stool, especially if 
costive. 

Further examination of the gland showed it to be 
excessively sensitive through the prostatic urethra and 
the rectum. The case was very hard to control, by way 
of relieving local irritation of the prostatic urethra and 
vesicles, which had been somewhat inflamed; but the 
excessive hyperesthesia was due to his long abstinence. 
This had been so reflected upon the prostatic ganglion 
and genito-spinal center as to perpetuate such a continu- 
ous reflex irritation upon the central nervous system, as 
to induce insomnia, melancholia, and nearly every form 
of neurasthenia (so-called), or nervous diseases- in gen- 
eral from head to foot. 

The treatment was tedious, in order to allay the inflam- 
mation of the prostate, seminal vesicles, and adjacent 
organs; also to allay the nervous irritability resulting 
from the nerve reflexes. 

Complete recovery ensued in four months. 

PROSTATITIS, EPILEPSY, PREPUTIAL IRRITATION. 

Case 6. Married; aged twenty-eight, thin, nervous, 
wild-eyed and as restless a man as I think I ever saw. 
He was born and raised in the country by an intelligent, 
well-to-do widow. At about fourteen he began mastur- 
bating, and at sixteen had epileptic fits. These assumed 
a periodicity and at first recurred about every; four 



141 

weeks, and then every two weeks, often followed by two 
or three attacks in one or the succeeding day. They con- 
tinued to grow more frequent and severe until he would 
have two or three attacks a week. He was at first treated 
by his local physician with bromides, which controlled 
them to some extent in frequency and severity, but at 
the expense of his physical and nervous system. He 
went the round of neurologists in New York, Cincinnati 
and St. Louis for ten years. The last physician, after 
having had him under treatment for more than a year, 
trephined him, as he said, for too much blood upon the 
brain. Still there was but little temporary relief. He 
had taken bromides until he was almost an imbecile, 
when he returned home. His local physician advised 
him to get married, which he did about nine months 
before coming under my care. 

The objective symptoms, as determined by an examina- 
tion, revealed phimosis in a marked degree, the glans 
penis and meatus being red and very sensitive. The 
urethra was so extremely hyperesthetic that an attempt 
at introducing a bougie almost threw him into convul- 
sions. The bromides were continued in small doses for 
a short time. -The epileptic attacks became less frequent 
and severe until they again assumed a periodicity, re- 
turning every twenty-eight days. The inception of his 
trouble evidently arose from preputial irritation from 
lack of circumcision. This offending factor was removed. 

Patient was under treatment fourteen months. For 
five months before he was dismissed he had not had an 
epileptic attack, nor had he taken a dose of bromide for 
three months. Eleven and one-half months from the time 
he began treatment his wife was delivered of a girl baby. 
The patient became quite strong and corpulent, returned 
to his mother 's farm, and I have not heard from him since. 



142 

Quite a number of cases similar to the last two have 
come under my observation. They were traceable to 
disease of the prostate and exhibited a variety of neurotic 
disturbances as a result of masturbation, continence, or 
excessive sexual indulgence. 

In many of these cases, as in this, the prepuce was 
unusually long, and had been producing much trouble. 
Had it been removed in youth or childhood there would 
in all probability have never been any trouble when he 
arrived at maturity. 

PROSTATITIS, VESICULITIS, PROSTATIC URETHRITIS, AND 

IMPOTENCE. 

Case 7. Single ; aged thirty- three. The only subjec- 
tive symptom of which this man complained was total 
impotency. Otherwise he was in fairly good health, and 
attended his business daily. He had never indulged in 
alcoholic drinking. He had masturbated some in early 
youth, but abandoned it quite soon for sexual indul- 
gence, which he carried to great excess. This inordinate 
indulgence was maintained for five or six years, when 
an impairment of function was noticeable. This condi- 
tion continued to grow worse, until a physician was con- 
sulted, who prescribed aphrodisiacs. Temporary excite- 
ment followed the use of the drugs, which was soon 
followed by complete collapse. Other drugs were 
tried without avail. The physician endeavored to per- 
suade him, as he had no apparent physical ailment, that 
"it was all in his head." He never had gonorrhea, or 
any kind of venereal disease. A second, third, and 
fourth physician was consulted; each of whom treated 
him similarly to the first without the least benefit. None 
of the doctors made a physical examination, as they took 
it for granted, that, as he had never had gonorrhea, 



143 

there was no lesion of the genital organs causing the 
trouble, This treatment extended over a period of six 
years, and, strange to state, no quack remedies were 
taken in all this time. 

Upon passing a bougie a boule, I noticed very little 
sensitiveness until the prostatic portion of the urethra 
was reached. Examination with the cystoscope revealed 
an inflamed and granular surface along the floor of the 
prostatic urethra. The other portion of the canal was 
normal. The prostate and vesicles were slightly tender 
upon pressure. As revealed through the proctoscope the 
rectal mucosa opposite the gland and vesicles was red 
and somewhat inflamed, but not abraded. 

He had occasional nocturnal emissions, at intervals of 
from three to four weeks. At times he would go six 
weeks without an emission, which is not considered 
abnormal in a man of his age ; but occasionally he had 
these emissions two or three nights in succession, and 
occasionally two the same night, which evidently was 
due to long continued use of aphrodisiacs. This case 
proved quite rebellious to treatment for a time ; but 
finally yielded in about twelve months. Conditions of 
congested inflammation of the genital organs and the 
genito-spinal center, as induced by stimulants given 
constitutionally to restore lost function, are usually much 
more difficult to relieve than are those cases where such 
drugs have not been given. 

PROSTATITIS, VESICULITIS AND URETHRITIS. 

Case 8. Single ; aged twenty-seven ; gonorrheal origin. 
This young man had gone the rounds of first the drug- 
gists, then the quacks. He was suffering intensely from 
dysuria, pain in the back, perineum and left groin. 
There was a gleety discharge, which, at times, was pro- 



144 

fuse, then again, very scanty. It was his first attack, 
and it had been running for eighteen months. 

His treatment had consisted of injections, systemic 
medication, irrigations and sounds. The meatus was very 
much contracted, and the urethra was tender throughout 
its entire course. There were localized patches along the 
canal much more sensitive than at other points. The rec- 
tum was quite tender and often protruded while straining 
to void urine, when at stool. The parts were so tender 
that I did not attempt a thorough examination at first. 

After the first acute symptoms had been allayed by 
the use of suppositories of boric-acid and belladonna, 
physical examination revealed three granular patches in 
the urethra; the first one inch back of the meatus, the 
second at six inches, and the last in the prostatic por- 
tion of the canal. The rectum was inflamed and abraded 
opposite the prostate, and very red and tender high up 
and about the vesicles. 

There are many cases similar to these with various 
nervous and physical complications. At times the heart 
becomes involved, — at other times they have a persistent 
hacking cough due to irritation, either of the pericar- 
dium or the pleural sac, as a result of acetonoemia. 
These cases are almost invariably despondent, and usu- 
ally have been the rounds of the quacks, after having 
at first taken treatment from their family physician. 
Most generally the latter simply prescribes some innoc- 
uous remedy, without making an examination or treating 
the organs that give rise to the trouble. There are but 
very few cases at such an early age that have not been 
the rounds; and most of them believe they are in an 
incurable condition; whereas the disease yields readily 
when appropriate remedies are applied to the organs 
primarily involved. 



145 

Many of these cases have either broken off their en- 
gagements to marry or have postponed it for a time 
without telling their affianced the real cause of the delay. 
In other instances men have been bold and frank enough 
to disclose the real nature of their trouble. In two or 
three cases of this kind the intended bride was the means 
of finding relief, having discovered the existence of this 
book through the medium of a book store or library. 

Case 9. L. J. W. Age 27; strong, robust, athlete, 
negative history, married, one child. Urine loaded with 
alkaline deposits and earthy salts; slight trace of albu- 
men, no sugar; Sp. Gr. 1028; temperate in habits. On 
November 28th, 1908, he incidentally mentioned the 
superior skill of his physician who had succeeded in 
removing calculi from his urethra and prostate, stating 
that he had been suffering with "uric acid diathesis" 
(as his physician termed it) for many years. I could 
not, at this time, tell this young man of the danger of 
these calcareous deposits or stones forming so large a 
mass, at times, as to make removal impossible, and that 
this same condition was apt to produce similar deposits 
or stones in other parts of the body, as in kidney, blad- 
der, the liver, the veins or arteries, as phleboliths, arterio- 
liths, and even gall stones, etc. 

About nine months thereafter he came to my office 
in great distress, stating that he was suffering intensely 
and could not void his urine; fortunately for him his 
physician was out of his reach, and he begged me to 
relieve him at once of his suffering, and the irritation 
resulting from the formation of a prostatic stone which 
was too large to be passed. I at once allayed the acute 
trouble, then relieved him of this prostatic calculus, 
which had grown until it was a half -inch long, ragged, 
and completely filled the urethra. It was with much 



146 

difficulty that the stone was removed. After I had 
accomplished this, I then told him of the danger of such 
stones forming at other points in the body, and thor- 
oughly convinced him that the cause of this trouble was 
due to a certain local inflammation disturbing first a 
special sympathetic ganglion and afterwards the vaso- 
motor system. 

After the calculus had been removed treatment was 
directed to allaying of all acute symptoms, the cause of 
the formation of the calculi was then located and re- 
moved. He has not had another one to form since — ■ 
three years ago. 

Case 10. D. E. W. Student; age 23; up to thir- 
teenth year he was in robust health ; then began having 
trouble with eyes, necessitating stopping school ; this con- 
tinued with headaches and restlessness at night; at 15 
returned to school, eyes worse and could not read a line, 
words running together and dark specks floating before 
vision ; stopped school and went on farm, where he worked 
until 17 ; again returned to school ; could not read a line 
and had his roommate read his lessons to him ; headaches, 
backaches and nervousness so severe that he would stand 
for a half hour with eyes fixed, partially crossed, so in- 
tense was the pain; he then developed epilepsy (petit- 
mal) ; first recurring every three months, then monthly; 
finally, grand-mal and daily; was given bromides until 
almost an imbecile; had nocturnal emissions, nightly, 
often twice ; could sleep only on right side ; was treated by 
several physicians, first by means of prostatic massage, 
then sitz baths and percussion baths, electricity, etc. ; epi- 
lepsy continued uninterruptedly; went to Battle Creek; 
no benefit. During early life suffered intensely from indi- 
gestion and was restricted to liquid diet, largely milk, 
which constituted his chief article of food. 



147 

Examination disclosed an exceedingly sensitive urethra 
from meatus to bladder, and introduction of flexible, 
soft bougie precipitated an epileptic attack, so very hy- 
peresthetic was this canal ; the rectum was almost equally 
sensitive. Treatment to allay these conditions was first 
instituted; then topical applications. Improvement be- 
gan at once, first by relief from headaches, then from 
indigestion. "Was also found to be suffering from slight 
sigmoiditis; after treatment by cataphoresis, passed a 
large tapeworm, and several days further treatment 
brought more worms. 

Will note here that observation has led the writer to 
believe that milk given to infants often produces these 
worms. 

Patient's epileptic attacks began gradually to subside, 
recurring monthly until they finally disappeared, and 
he has not had an attack now for eighteen months ; 
returned to his school work and finished his education. 

Case 11. J. W. B. Stenographer; negative history; 
age 23. Up to his seventeenth year he was a model 
young man and in perfect health. He had been a Court 
stenographer, which implies that he must be expert to 
hold such position. His was almost an exact counter- 
part of the preceding case. I never studied two cases 
more intently in my life than I did these cases. This 
latter one was more morbidly afraid of his weakness 
than the former. He could not be sent one block distance 
on an errand, for fear he would never return. He would 
always beg piteously for carfare. On one occasion he 
was sent a mile distant and he lost his return nickel. 
He struck out for home as fast as he could possibly walk, 
and completed the entire distance without apparent 
harm, showing that this fear was morbid. He, too, com- 
plained of sleeping not over two or three hours during 



148 

the twenty-four. The man was very reticent, and I 
think very truthful. Although in good flesh, he main- 
tained at all times that he was extremely weak. The 
case passed out of my mind several years; but finally 
after a search I located him and induced him to return. 
He still suffered as before. Physical examination re- 
vealed two py-ro-saks and one overticula. These were 
removed, and this young man is now rapidly recovering 
his health, and has much more confidence in himself than 
has the former patient. I shall keep him still under sur- 
veillance to note the ultimate result. 

It is just such cases as these, no doubt, that result in 
suicides, and I had fear that both of these would finally 
terminate in that way. 

Case 12. B. D. C, age 32 ; single ; farmer ; negative 
history. He was a strong healthy boy up to his four- 
teenth year. While plowing he would give out quickly, 
and would have to stop and sit down at end of each row 
to rest. His mother, a widow, insisted upon his work- 
ing to support the family. His nervous condition con- 
tinued to grow worse until he would become sleepless 
in spite of being wholly exhausted upon coming home 
after his day's work. Appetite was good, though suf- 
fered from gaseous indigestion and constipation. He 
continued to grow worse from year to year, until at 
seventeen he began having epileptic attacks about once 
every three months. He would sit for hours at a time, 
his mind apparently blank, unable to remember any- 
thing about which he had been thinking. His family 
thought it all laziness, and persisted in their efforts to 
make him work. Dosed upon bromides until almost im- 
becile. He obtained a position in a printing office, but 
was unable to hold it on account of his wandering mind 
and repetition of the same thing. Although well devel- 



149 

oped and apparently a strong man, lie claimed to be 
unable to walk a block's distance without rest. Was 
examined and treated by a specialist in Omaha, who 
decided that he had prostatic trouble. He continued to 
grow still worse, and after the treatment by the Omaha 
physician a physical examination by me revealed chronic 
prostatitis, endocarditis, acetonemia, blood 70 per cent. 
His pulse would vary, at times was strong and full at 
96, and at other times extremely oscillating from 90 to 
110. The variation was much more marked upon stand- 
ing than while sitting, 90 seated — 115 standing. Two 
overticula were removed, and at the end of six weeks he 
was apparently well, except that he still complained of 
extreme weakness, and went home with a view of trying 
plowing and farm work again. I insisted upon his 
exerting himself regardless of how exhausted he might 
become, and upon his continuing until he became so tired 
as to make him sleep at night. He was constantly and 
morbidly fearful that he would not sleep at night; would 
lie with his eyes open, as he termed it, "watching with 
the owls." "I have spent fully four-fifths of the nights 
during the past nine years in trying to sleep. I have 
counted backward until I can count almost as well back- 
ward as forward. I have tried all kinds of schemes to 
induce sleep. I have walked in the snow barefooted 
until my feet would ache, yet the pain was nothing com- 
pared with that of insomnia, and the dread of not sleep- 
ing." Apparently was a bright, intellectual young man. 
His mother also insisted, after I had written to her, upon 
his working regardless of his exhaustion, and he was at 
the same time directed to take physical exercises, night 
and morning, by means of various movements and con- 
tortions of the body. For the first year after his return 
home he wrote me often, constantly begging for medi- 



150 

cines to quiet his nerves and to make him sleep. I dis- 
regarded his request. About three years after his return 
home I wrote to him to learn of his condition ; he replied 
it was about the same as when he left. I advised him 
to return, as I had found some new lesions in others 
which I suspected that he probably had, concealed in 
some organ that I had overlooked. He promptly re- 
turned; to my great surprise he had gained over thirty 
pounds in weight, and was apparently strong and robust, 
red faced, blood 95 per cent. He still complained of 
melancholy, insomnia and weakness, although he ad- 
mitted that he was much stronger than when he left. 
His physical appearance would indicate a perfect ath- 
lete. The only abnormal symptom was in his speech 
and in his eyes, which were constantly dancing; and 
though he could look one straight in the eye, there was 
a twitching and nervous movement. The first day, upon 
examination, I discovered a ' ' py-ro-sak. ' ' Upon advis- 
ing him to return to his room, he at once began his old 
tactics of begging for medicines to quiet his nerves and 
make him sleep. I asked him if he had ever taken such 
medicines, and he replied "no;" and when I asked, 
"why do you want to take them now," he said, "I am 
afraid that after this operation I cannot sleep." I made 
every effort to learn whether he had been addicted to 
any drug habit. Reports from his home, as well as my 
own investigations, proved negative. After a month or 
six weeks he returned home. That is now a year and a 
half ago ; and, although he still complains, his sister 
writes me that he is in perfect health apparently. 

Case No. 13. W. J. B. ; barber ; age 29 ; single ; 
negative history; Illinois; urine, ammoniacal color, acid 
reaction; normal specific gravity, excessive urea; from 
seventeenth year had suffered occasionally from attacks 



151 

cf what he called ' ' rheumatism ' ' ; had also suffered with 
pericarditis and shortness of breath, could not walk two 
blocks without tiring very much, and could not run 
upstairs; pulse 90 to 105. At 23 years of age he was 
compelled to go to Hot Springs, Arkansas ; greatly bene- 
fited and returned to his work ; recurrence of his ' ' rheu- 
matism"; his ankles were very much swollen, especially 
at times when standing about his chair. Two years 
after returning from Hot Springs went to Mount 
Clemens, took baths, and benefited until his money run 
out and his physician sent him to me, telling him I 
could cure him. 

Physical examination revealed an exceedingly sensitive 
urethra, granulated prostatic urethritis and at neck of 
bladder; gland slightly swollen; slight acetonemia. 
Treatment to allay the acute sensitiveness and to neutral- 
ize the urine, began at once to show improvement in his 
limbs, and at the expiration of six weeks the swelling 
had all left his ankles; his heart had regained normal 
action ; returned to his work and reported, as requested, 
once in every three months for a year, and has had no 
return of his trouble. 

Many cases similar to this have come under the ob- 
servation of the writer in which lesions of the prostatic 
urethra or of a certain portion of the neck of the blad- 
der cause an acid urine by disturbance of the circulation 
by way of the controlling ganglion. This state of acidity 
affects practically all the serous membranes, including 
the synovial of the joints (rheumatism), the pericardial 
membranes of the heart, and the pleural sac encompass- 
ing the lungs. The synovial membranes are especially 
affected because they are aggravated or provoked to an 
inflammatory condition by friction in walking, and there 
is a constant movement of the heart in its action of sys- 



152 

tole and diastole ; as a result the same condition arises 
therein. It is generally known, not only among the pro- 
fession but among laymen, that heart diseases are in 
some way associated with rheumatism, and it is the con- 
current opinion that rheumatism produces heart troubles. 
This is an erroneous idea ; the heart trouble results from 
the acid condition of the blood affecting the serous mem- 
branes of the heart (pericardium), in the same way as 
"rheumatism" is caused by acid condition prevailing 
in the blood and affecting the synovial membranes of 
the joints. Relief of the local condition (the acidity), 
which gives rise to the irritation of the ganglion, which 
in turn disturbs the vaso-motor system (the primary 
cause), will remove the whole trouble. As a matter of 
fact there is no such disease as rheumatism; it is only 
an affection of the joints and serous membranes, and 
results from these membranes taking on acute inflam- 
mation through the acid condition referred to. Gout 
is popularly associated with rheumatism, when as a 
matter of fact, there is no physician who has ever drawn 
a line of distinction between gout and rheumatism, and 
their conditions. The only distinction that can be made 
is that gout affects the joints of the toes, and of the 
feet, especially of lazy men who sit about and become 
indolent ; and it is due to the fact that the toes are more 
distant from the heart, and more pendulous, requiring 
greater effort to force the blood through these extremi- 
ties and bring it back to the heart. 

I shall call especial attention to the fact that this man 
had no gonorrhea, and never had had any symptoms of 
it, yet he had the same conditions of local inflammation 
of the synovial membrane as those cases that had had 
gonorrhea. In other words, his condition was followed 
with the same inflammation of synovial membrane as in 



153 

those cases that had acquired the specific germ, and 
what was ordinarily termed "gonorrheal rheumatism. ' ' 

Many of the men having the local trouble above de- 
scribed (in the prostate and vesical neck), and also hav- 
ing ' ' rheumatism ' ' ; are told that they suffer from ' * gon- 
orrheal rheumatism " when in point of fact, many cases 
absolutely free from any gonorrheal taint have these 
" rheumatic ' ' troubles, just as often as those who have 
had gonorrhea. 

Case 14. K. C. B., age 56 ; married ; one child ; nega- 
tive history ; very corpulent ; swarthy in appearance ; 
easily fatigued upon walking ; slight endocarditis ; irreg- 
ular pulse ; mild insomnia. 

Nine years ago he consulted the writer for partial 
paralysis of his left arm. It began with pricking, ting- 
ling sensation in his fingers, then extended up the arm 
to his shoulders with constant pain in region of scapula 
and pectoralis muscles. This condition had been present 
for twelve or fifteen years prior thereto, gradually grow- 
ing worse daily. He had consulted a number of physi- 
cians, some of whom told him it was a mild, creeping 
locomotor-ataxia ; others approaching paralysis. He was 
treated by every form of pathy, every form of electricity 
and local applications, with negative results. 

Physical examination revealed chronic prostatitis and 
parenchymatous inflammation of the prostate. Relief 
was soon obtained, and following relief of this local 
trouble the symptoms gradually began disappearing 
from his arm and shoulder, and in three months' time 
he was dismissed well. 

June 10, 1913, the same man returned, stating that he 
had never had any further trouble with his prostate, or 
with his arm since he was cured nine years prior thereto, 
but that he had another trouble that was annoying him 



154 

very much, and apparently it was the only thing that lay 
between him and perfect health. 

This consisted of a constant itching about the anus. 
Around the perineum and upon the buttocks and back 
there were numerous small, purulent eruptions, which 
would break out, itch a few days, then form a scab, and 
dry up, when others would take their place, growing 
more numerous from day to day and week to week, until 
the entire back became studded with these eruptions. 
Examination revealed a " py-ro-sak, ' ' which was re- 
moved and relief followed. Four days thereafter, he 
returned, stating that he had never felt better in his 
life, and that aside from this eruption, he was in perfect 
health. Between the age of 18 to 25 years he had never 
missed a day when he was not necessitated to take any- 
where from two to twenty doses of bicarbonate of soda 
to relieve a gnawing condition of his stomach. On the 
day after this "py-ro-sak" had been removed, he had 
not taken a single dose, nor has he taken any up to 
the present time. The eruption on his back and around 
the perineum has entirely disappeared, his skin has 
assumed a natural appearance, and he is growing in 
strength from day to day. 

The "py-ro-sak, "to which reference was made, con- 
tains from a few drops to half dram of sanguino-puru- 
lent matter, which is being constantly absorbed, satu- 
rating the blood therewith and rendering it a fertile 
soil for the development and propagation of any germs 
that may enter the system. This pus not only supplies 
the pabulum requisite for these germs, but at the same 
time it serves to destroy the normal protoplasm, or cyto- 
plasm, of the cells throughout the body, and wherever 
this pus is absorbed in large quantities it forms in com- 
bination with fat cells an unhealthy matter that dis- 



155 

places the normal cytoplasm, thereby causing an un- 
healthy fatty or waxy appearance throughout the body ; 
and even within the heart itself, this " fatty degenera- 
tion " is constantly taking place. Just as soon as the 
cause is removed (the source of supply of this pus to 
the blood) normal conditions are restored to the entire 
body, and life greatly prolonged. 

This case illustrates many others that have come under 
the observation of the writer, where pyogenic matter is 
converted into either abnormal fat and takes the place 
of protoplasm within the cells of the body, or it forms 
with mucus another form of degenerative substance that 
is deposited as a thick, tenacious, colloid structure. It 
also causes hyaline metamorphosis, and colloid and amy- 
loid degeneration (often found in the kidneys), which is 
frequently called on account of its waxy appearance, 
lardaceous degeneration, or tube-casts by others. 

These tissue degenerations, or metamorphoses, that 
take place as a result of destructive transformation, are 
often mistaken for degeneration of the organ itself. Espe- 
cially is this so with reference to the kidney, the spleen, 
heart, lungs, and liver, when in point of fact, these 
organs are rarely primarily involved, and their affec- 
tions result as sequels to lesions in other organs far 
remote from them. In fact, it is rare for these organs 
to become idiopathically involved. 

I can better illustrate the various lesions that give 
rise to practically ninety per cent, of all the diseases 
with which we come in contact, by clinically demonstrat- 
ing from authentic cases that have been of long stand- 
ing, and have resisted practically every other mode of 
treatment. Some of these had previously gone under 
the knife, with a view of clearing up an obscure diag- 
nosis. 



156 

Case 15. D. J. B. Age 34; gonorrhea at 20, never 
entirely recovered ; single ; in good weight and apparent 
health, though appetite poor; limbs heavy and swollen 
above ankles ; ' l rheumatism of the ankles, ' ' as he termed 
it; heart very weak, with endocarditis; had retention of 
urine twice; eyes bulging with dark rims around them; 
blood 80 ; urine loaded with pus and mucus ; exceedingly 
nervous ; had been a hard drinker at one time ; three 
years prior was treated with 606; has been staggering 
in his gait ever since and walks with considerable diffi- 
culty; while at Hot Springs (where he had been twice 
before) he was informed that nothing could be done for 
him, and was referred to the writer by Br. "Walker. 

Physical examination revealed an exceedingly sensitive 
urethra throughout, prostatic portion being tender and 
painful; granulations throughout prostatic urethra and 
neck of bladder with mass of proud flesh obstructing 
flow of urine. Had been a noted athlete, taking several 
prizes in athletic contests ; over-exertion had caused dila- 
tation of heart from which he has never fully recovered ; 
his pulse has receded from 96 to 108, down to 78 and 84. 

After relief of the acute symptoms, complete restora- 
tion to normal health of the heart, and all other organs 
followed. 

Case 16. J. B. S., age 22, no hereditary tendency. 
Up to his twentieth year was in perfect health, then 
contracted gonorrhea — was treated for six months, was 
left with chronic inflamed bladder and pelvis of kidney. 
His mother being a widow and he her only support, 
came with the young man to see me. For the previous 
twelve months he had a constant cough, and during the 
past six months he had been losing flesh, strength and 
appetite rapidly, with profuse purulent expectoration. 
Two physicians had treated him for "tuberculosis"; a 



157 

third called in consultation corroborated their diag- 
nosis. A friend of his, whom I had cured, insisted upon 
his coming to see me. Both he and his mother were 
firmly convinced in their minds that it was true tuber- 
culosis ; and the boy had not worked for several months 
on account of his prostration. They were extremely 
hard to persuade that the cause of his trouble was the 
gonorrhea. They both admitted that he had been in 
perfect health before that, and that the " tuberculosis ' ' 
followed immediately upon the result of the harsh treat- 
ment he had received, setting up the inflammation of the 
genito-urinary organs ; but they believed, as I told them, 
that they had nothing to lose, as the boy would die un- 
less he procured relief. They reluctantly allowed the boy 
to submit to treatment, which consisted in the allaying 
of the sub-acute inflammation of the prostate, of the 
bladder, of the seminal vesicles and the pelvis of the 
kidney, all of which were involved, thus supplying am- 
ple food for the development of any pathogenic bacteria 
that might enter the blood. Five days after beginning 
treatment, the prominent symptoms of pyrexia, insom- 
nia, irritative cough and purulent secretion had greatly 
subsided, and his appetite began to be ravenous, so 
much so that it was necessary to control it, as he failed 
to digest all he ate. Complete recovery, back to work in 
five weeks from the time he began treatment, and he has 
not had any sign of "tuberculosis" from that day to 
this. 

Case 17. L. C. B., aged 32 ; strong, healthy man up to 
twenty-first year. No hereditary idiosyncrasy, con- 
tracted gonorrhea when twenty-two, long tedious recov- 
ery, as he supposed. In fact, he never recovered. He 
suffered with an occasional cystitis, prostatic urethritis, 
and gleety discharge. At the age of twenty-four, he 



158 

I 

began having a hacking cough. His family physician 
had his sputum examined, and his ailment was pro- 
nounced ' 'tuberculosis, ' ' He left for Colorado, where 
he remained (in Denver, Breckenridge, and other places) 
for four years, returning home with but little improve- 
ment. "When he consulted the writer he was hacking 
incessantly with profuse, purulent discharge. He was 
so weak that he had to be supported on the arm of his 
mother and brother. It was quite difficult to convince 
him or his mother, that his ' ' tubercular trouble ' ' might 
originate from his gonorrhea, although it was made 
plain to them that he had never had any symptom of 
that trouble prior to the attack, nor did he have any 
symptom until two years later. I endeavored to per- 
suade them that it was possible for the gonococci to have 
become imbedded within the prostate, vesicles or some 
other organ, and poisonous matter secreted by them to 
have become absorbed, and infected his system to such 
an extent as to give rise to his present trouble. He 
finally, although reluctantly, consented to treatment; 
when examination disclosed excessive hypesthesia of the 
entire urethra, and inflamed prostate and vesicles. Im- 
mediate relief followed treatment of these local troubles, 
and at the expiration of six weeks ' time he was dismissed 
a sound, healthy man, and has never had a day's illness 
since. 

In connection with this case and many others similarly 
affected, although with not so profuse purulent sputum, 
but an irritative cough, removal of the local lesions 
within the prostate, urethra, rectum, sigmoid or other 
organ, has given almost immediate relief to the irritative 
cough. How is it possible for "tuberculosis" to have 
become a prominent factor in these cases (and there are 
many similar ones), where such symptoms have been 



159 

prominent, and pronounced "tuberculosis" of ten, fif- 
teen, twenty-five or more years' standing, and entire 
relief obtained as soon as the local primary cause was 
removed ? 

These cases are not rare, and in fact they have come 
within the observation of most every man or woman 
who has reached maturity, and taken notice of such cases. 
The writer himself has had almost an incessant cough, 
and purulent expectoration (which had been examined 
and pronounced tubercular), also frequent hemorrhages 
for the past twenty-five years. These symptoms readily 
subsided upon resting. A Mr. Bwing, with whom I was 
acquainted many years, was similarly affected, having 
had numerous pulmonary hemorrhages about his thirty- 
fourth year — he lived to be ninety-four. 

Case 18. J. B. W., aged 26 ; no hereditary tendency ; 
up to his twenty-fourth year he was in perfect health; 
traveling man; contracted gonorrhea at the age of 
twenty-four. He had been treated by strong injections, 
causing stricture, then by various methods of sounds, 
finger massage, irrigations, etc. Eighteen months ago 
he developed an irritative cough. This continued to 
grow in frequency of attack until he was coughing 
almost one-half of the time. There was no purulent 
secretion at first, but the constant coughing excited ten- 
derness, then pain, then purulent secretion of the lungs. 
Examinations by different physicians pronounced his ail- 
ment "tuberculosis" ; he claimed there was no hereditary 
tendency; there was no cough prior to the gonorrheal 
attack, and it was extremely difficult to convince him of 
any connection between this attack and the subsequent 
effect. He finally yielded to examination, which re- 
vealed a tender inflamed urethra, from the meatus to 
the bladder, also tender prostate, and excessively tender 



160 

vesicles, mucopurulent discharge, with slight indica- 
tions of pyelitis. Relief of these gave immediate relief to 
his cough, and it entirely disappeared with all purulent 
secretions, seven weeks thereafter, when he was dis- 
missed, cured. This case has been under observation 
for the past three years; he has remained well, gaining 
twenty pounds in weight. 

Case 19. Male ; aged 36 ; merchant, married, two chil- 
dren, negative history. Five years ago he began suffer- 
ing with periodic attacks of coryza, beginning about the 
first of July, extending six weeks to two months. At 
first of mild character. Each year growing more aggra- 
vated until finally (almost three years ago) he began 
suffering from hay-fever, of an aggravated form, and 
necessitating his moving to a high altitude, then to dif- 
ferent climates with only temporary relief. Each year 
seemingly growing worse. During the past year he began 
assuming attacks of asthma, difficulty of breathing, in 
walking up-steps, especially during wet, damp, hot 
weather. On the 1st of March he consulted me for 
" neurasthenia ' ' as he called it, of such aggravated 
form that he could only sleep three or four hours during 
the night. Appetite good, strength fairly good, yet he 
showed a wild, anxious appearance about his face, and 
especially in his eyes. Examination revealed little pros- 
tatic trouble, no enlargement of the gland, but hyper- 
esthesia of the prostatic urethra ; at times voiding urine 
frequently, at other times almost normal. He was dis- 
missed the first of April, cured of local troubles. His 
condition has been watched with extreme anxiety. The 
7th of July reported well ; the 15th of July he reported 
some slight symptoms of a return. On the 21st of July 
the symptoms were more marked, but still he could not 
say that it was his old attack of hay-fever. During this 



161 

time neurasthenia had completely subsided — sleeps well, 
eats well, works well. On September 24th, report was, 
entirely free from all symptoms ; the first time he was 
free from hay-fever for three years. 

Case 20. J. A. "W., aged 34 ; single ; nine years pre- 
viously had contracted his first case of gonorrhea. Three 
years thereafter he had what he supposed to be a second 
case, and a third attack shortly afterwards. For the 
past three years he has suffered intensely from acute 
attacks of chronic prostatitis, cystitis, vesiculitis and 
pyelitis. These troubles would produce an acute exas- 
peration at different intervals, sometimes monthly, then 
again weekly; these were attended with straining at 
stool as though the bowel was filled with something 
abnormal that could not be expelled. This was followed 
by violent nausea and vomiting, which would last for 
three or four days. Several times during these attacks, 
he would go into convulsions, which would last ten to 
thirty minutes; then again from half an hour to an 
hour, he becoming unconscious during these long at- 
tacks. On recovering from one he would be extremely 
nervous, restless, devoid of appetite, and suffer with 
insomnia, necessitating the giving of hypodermic injec- 
tions of morphia. These spells continued to recur more 
frequently and with greater severity month after month, 
although he consulted the best physicians within his 
reach. They were apprehensive of a fatal termination 
to each spell. Owing to the absence of the writer, the 
man had postponed coming for several months; but 
when I returned to the city his attending physician, Dr. 
Maloney, who had read my book, directed him to come to 
me. 

Upon his arrival, physical examination revealed an 
exceedingly neurasthenic condition, cystitis, pyelitis of 



162 

very aggravated condition, and py-ro-saks. All of 
these, however, yielded readily to treatment, with the 
exception of pyelitis which was persistent, and the 
nausea and vomiting. They were recurrent attacks of 
vomiting for three weeks during the course of his treat- 
ment. 

The condition of the prostate, bladder, and vesicles, 
had provoked an unusual sensation throughout the rec- 
tum and sigmoid-flexure. 

Vomiting and nausea occurred in the morning accom- 
panying priapism. Both of these symptoms were ag- 
gravated as the priapism became more severe in char- 
acter. This condition lasted quite a while, and at times 
there was much difficulty in voiding urine. The nausea 
and vomiting became so excessive as to last throughout 
the day; then as the disease of the gland progressed 
they became so intense as to be uncontrollable except 
by large hypodermic doses of morphia. When the pa- 
tient came to me these paroxysms often lasted three 
days, rendering him cyanotic. He had been treated for 
the nausea and vomiting and for rigid contraction of 
the abdominal muscles for three years by several phy- 
sicians, not one of whom had ever thought of the pros- 
tate or adjacent organs as being the excitant cause, 
until his case was undertaken by Dr. Maloney. All the 
symptoms gradually subsided at the expiration of two 
weeks after treatment commenced, and the relief of the 
acute symptoms of the prostate was also effected. The 
nausea was quite persistent at times, and although I had 
cut off all the opiates, he begged for them the first few 
times he had an attack. It was six weeks after begin- 
ning treatment before the nausea entirely disappeared. 
One morning he came into my office with a bright, laugh- 
ing, countenance, saying, "This is the first morning I 



163 

have experienced for three years when I did not wake 
up nauseated and often starting to vomit, which feeling 
would last at times several days." His progress was 
slow, but uninterrupted, until he was dismissed, three 
months thereafter, a sound, well, and happy man. This 
is the first case I ever had where organic lesions were 
not prominent, that was attended with such persistent 
nausea and vomiting. I am now prepared to attribute 
any form of chronic disease to one or the other of the 
causes mentioned in this book. During the past few 
years I have not been disappointed in a single case. 



CHAPTER V. 

CONGESTED GLANDULAR ENLARGEMENT OF THE PROSTATE, 

VESICULITIS, COMPLICATIONS OF CYSTITITIS, VEGETABLE 

GROWTHS, PROUD FLESH, POLYPI, ETC. 

This affection of the gland is common in middle 
age, and occurs most frequently between the ages of 
thirty and sixty. It is, howeved, not infrequent as early 
in life as twenty-five and even past seventy, without 
the existence of true indurated senile hypertrophy. I 
have had three cases — one seventy-two, another one year 
older and a third seventy-nine — with congested enlarge- 
ment, and inflammation of the gland, seminal vesicles 
and neck of the bladder, without fibrinous induration 
or true senile hypertrophy. 

This condition of enlargement of the gland is exceed- 
ingly common. In fact, statistics as recently compiled 
by the writer, taken from upward of 8,000 cases, show 
that there were 106 cases of this nature of enlargement 
(that is, inflamed swollen enlargement) to one case of 
senile hypertrophy. That is, practically only one per 
cent of the cases of congested enlargement of the gland 
are cases of true senile hypertrophy. 

Figure XVIII illustrates this form of enlargement of 
the gland. It also illustrates the extension of congested 
inflammation of the neck of the bladder. It may, how- 
ever, extend and involve the entire bladder unless the 
condition is relieved in the prostatic urethra or at the 
vesical neck. The inflammation also extends to the rec- 
tum as is shown by the red. The most serious extension 

164 



165 




Figure XVIII. 



166 

of this inflammation, however, is through the ejaculatory 
duct to the seminal vesicles, involving these latter organs 
in thickened induration and inflammation of the walls. 
This also frequently causes inflammation of the mucosa 
of the rectum, as they are in relation to these vesicles. 
Then, too, another most serious complication following 
this trouble, is the extension of the inflammation of the 
bladder to the orifices of the ureter; so that the inflam- 
mation extends up the ureters to the pelvis of the kid- 
ney, involving the latter in an inflammatory condition, 
and resulting in serious or sometimes fatal disease of 
the kidney, unless the condition is promptly relieved. 

The idea, so generally prevalent among the profession, 
that, when a man past forty or fifty has any disease of 
the prostate, it is indurated hypertrophy and incurable, 
is thus erroneous. This disease of the gland is one of 
passive venous congestion, submucous infiltration and a 
swollen enlargement of the organ, which generally re- 
sults in inflammation not only of the gland itself, but 
of most all the other pelvic viscera. It is somewhat 
analogous to the congested and inflamed condition of the 
uterus and its appendages. Not every woman that has 
venous stasis and an inflamed womb has fibroid tumors 
developed within its walls. In fact, the latter condition 
is rare as compared with the number of cases of the 
former. In like manner fibrinous tumors, or hyper- 
trophy of the prostate, is rare as compared with the 
numerous occurrences of congested enlargement. 

I have treated quite a number of cases of this class 
of prostatitis, that had been treated by different physi- 
cians for many years, and pronounced hypertrophy and 
incurable. Some of these cases had not only been treated 
by the family physicians, but by many of the leading 
specialists in this line of practice. 



167 

It is somewhat difficult in some cases to differentiate 
at first between congested enlargement and fibrinous 
indurated hypertrophy. The diagnosis will be consid- 
ered more at length under the head of diagnosis that 
will follow upon this subject. I shall add here, how- 
ever, that, basing a statement upon my own clinical 
experience, at least twenty cases of congested enlarge- 
ment of the gland occur to one of hypertrophy. I do 
not include in this estimate chronic prostatic folliculitis 
common to young men. 

Cause. The most potent etiological factors, produc- 
tive of this form of disease of the prostate, are common 
with those that excite chronic inflammation of the gland 
as detailed in Chapter IV. "When folliculitis is not 
arrested and it is permitted to extend and induce paren- 
chymatous prostatitis and plastic exudation, interstitial 
infiltration is the natural sequence. The exudate, thus 
produced, extends to the muscular fibers, and its pres- 
sure upon the blood and lymph vessels increases stasis, 
and chronic enlargement and inflammation of the entire 
gland results. 

Inordinate indulgence in alcoholic liquors, whether 
characterized by excessive bouts of drinking or a mod- 
erate though constant habituation, excites and increases 
congestion of the gland ; and, where any previous lesion 
of any part of the genito-urinary tract exists, it is ag- 
gravated. Especially is this fact more apparent when 
beer or fermented wine is employed. 

Since it has become a proven fact that, in from sev- 
enty-five to eighty-five per cent, of gonorrheal cases, the 
cocci invade the gland, and there remain dormant indefi- 
nitely, producing poisons that maintain a slow though 
constant irritation, besides that engendered by the germs 
themselves and the debris of their cadavers, chronic 



168 



inflammatory enlargement of the gland should receive 
more prompt attention than is generally given to it. 
One reason that it fails to arouse the uneasiness its im- 
portance demands is because of the insidious manner of 
the progress of the disease, and of the variable character 
of the subjective symptoms. At times all symptoms 
may be lacking, or they may recur in a somewhat ag- 
gravated form, necessitating the consulting of the fam- 
ily physician, who may not give it the attention requi- 
site, and usually dismisses the case, without examination, 
by prescribing a diuretic, and thus permits the extension 
of the pathological condition, not only to the gland, but 
to the adjacent organs. 

Lesion of the gland, whether of gonorrheal origin or 
due to other causes, is more easily excited by stimulants, 
at least for a time, until a complete breakdown follows. 
In other instances the irritation arising from lesion of 
the gland, whether due to dissipation or to other causes, 
creates an insatiable sexual desire, that affects the central 
nervous system to such an extent as to cause mental dis- 
turbances of various kinds. Such persons are often too 
modest to reveal all the facts to their family physician, 
and frequently endeavor to deceive even the specialist 
whom they may consult. It is much better, in such cases, 
for total impotency to supervene than to provoke an 
immoderate drain upon the nervous system, by excessive 
sexual congress, which often results in paresis, impaired 
memory or even insanity. It was no doubt due to this 
fact that only a few years ago castration was advocated, 
and performed quite frequently for insanity. It was 
claimed that marked relief followed the operation in 
some cases, while others were reported as cured. 

The great majority of these cases developed either 
serious nervous troubles or insanity. The result was 



169 

jthat Dr. White, the originator of this theory, had but 
few followers; and even these few soon abandoned it 
as impracticable, as did Dr. White himself. 

Ulceration of the rectum, whether resulting from pros- 
tatitis, is usually concomitant therewith, or, originating 
from other causes, evidently provokes and maintains 
prostatic congestion and inflammation, on account of its 
being in such close proximity to the gland. 

Horseback riding, and especially in those who do very 
much of it, aggravates an existing prostatitis, even 
though it may not be the prime cause of it. I have 
found this trouble quite prevalent among country phy- 
sicians, who are compelled to visit their patients on 
horseback. Bicycle riding has equally as bad, if not 
worse, effect upon the gland. I do not think moderate 
riding either upon a horse or wheel has any injurious 
effect upon the prostate, when it is in a healthy condi- 
tion, and the rectum is free from ulceration. The irri- 
tation is transmitted to the gland by the saddle through 
the rectum and lower urethra. 

Cold often excites congestion of the prostate; and 
when exposure to cold is frequent or prolonged the 
already inflamed gland becomes specially aggravated. 
Violent and long continued use of surgical instruments 
is a potent cause of enlargement of the organ, especially 
when large sounds are applied, pressing upon the already 
inflamed gland. The practice is a common one and is 
generally advised by surgeons ; and, in fact, it is almost 
universally used. Unless the sound is handled by a 
skilled operator the end of it strikes the gland in such 
a way as to do much harm. Even the most skillful 
operators frequently provoke serious troubles by means 
of sounds. 

Strong injections and cautery applications to the pros- 



170 

tatic urethra often produce serious trouble. The admin- 
istration of aphrodisiacs for impotency, which is a com- 
mon symptom of this disease, has a pernicious effect upon 
the gland. *The exciting "by these medicines, of a diseased 
gland, incapacitated for its normal function, to produce 
an abnormal congestion and orgasm, often provokes seri- 
ous trouble. It is a very general practice to give these 
remedies in a blind manner, without having examined 
the prostate with the view of discovering the real cause 
of the trouble. 

Symptoms. The symptoms are somewhat similar to those 
of chronic prostatitis of young men, except that, in this 
form of disease, there are more complications, and, in 
some cases, a higher degree of inflammation, as a result 
of the large size of the gland impeding the free flow of 
urine. Often vegetative growths or proud flesh spring 
up in the prostatic urethra, and around the vesical neck, 
which at times project into the anterior part of the 
bladder. These often develop into polypoid tumors, that 
flop about the neck of the bladder like a valve, and shut 
off the flow of urine, for a time. These polypoid tumors 
are very vascular an dinclined to periodical hemor- 
rhages. They often bleed freely while being treated, or 
when a sound is introduced. 

Almost every form of unnatural discharge from the 
urethra is commonly termed prostatorrhea, and these 
discharges are often taken as symptomatic of sperma- 
torrhea. Some of these may be so slight as to appear 
only as the "morning drop," or in the form of gleet; 
or it may precede the flow of urine, when it has accumu- 
lated within the prostatic urethra, in the form of a milky 
fluid. Others have the white discharge just at the ces- 
sation of the passage of the urine. When the latter 
occurs in mild form it usually proceeds from the pros- 



171 

tatic ducts; and by spasm of the sphincter urince in 
expelling the tardy urine, ejects also this secretion. In 
other cases, and especially when vesiculitis coexists, 
spermatic fluid may also pass. These fluids are usually 
mixed with pus and mucus. 

The urine in these cases is almost invariably abnormal. 
Its changed condition depends mostly upon the extent 
of lesion, the size of the gland, the length of standing, 
the bladder complications, and the amount of obstruc- 
tion to the flow of urine. The vesical neck is the first 
part of that viscus to become involved in ulceration, 
and, in most cases, this does not extend further, unless 
of very long standing. If of long standing it involves 
the bladder, the seminal vesicles, and often the pelvis of 
the kidney, in succession, rendering the trouble serious 
or even dangerous. The urine generally changes from 
its normal acid reaction and aseptic condition to that of 
alkaline, and is no longer innoxious to bacteria, but 
readily favors the development of pathogenic bacteria. 
The action of bacteria upon exfoliated mucus favors 
pyogenesis and the production of ammoniacal urine. 
The latter is exceedingly irritating to the bladder and 
especially at the neck, causing frequent and painful 
urination. This is particularly noticeable during the 
day, when standing or walking, as the urine gravitates 
to the neck or tender part of the bladder or prostate. 
The prostatic urethra, being, as a rule, the most sensitive 
part of the genito-urinary tract, is often rendered spas- 
modic by the acrid urine, whether due to alkaline or 
acid conditions, and causing an unpleasant sensation of 
still more urine to be voided even after the evacuation 
of the bladder ; or it may cut off the flow for a few mo- 
ments, when it again relaxes, and allows the passage of 
a small quantity of the urine. The irritation of the 



172 

gland or bladder is frequently reflected to the kidneys, 
causing polyuria, that is mistaken by many for diabetes 
or Bright 's disease. This condition may last a long 
time without effecting any organic disease of the kidneys. 

Systemic disturbances are quite common, either as a 
result of metastasis, or as a direct sequel to disease of 
the gland. Toxins or ptomaines emanating from the 
latent gonococci, and carried by the blood currents to 
the joints, nerves, and serous membranes, induce meta- 
static diseases, as synovitis, rheumatism, neuralgia, peri- 
tonitis, perityphlitis, pericarditis, and various other 
troubles, anywhere from the back of the neck to a pain 
in the heel. 

The sciatic nerve, or some of its branches, is the nerve 
most frequently affected by direct or reflex disturbances 
arising from disease of the gland. Pain over the hip or 
in the calf of the leg is common. This pain may also 
extend to the back, and the use of one or both legs may 
become impaired. 

There is often tenderness in the region of the peri- 
neum, or a dull heavy aching sensation, which is felt 
while standing or sitting. I have known some who could 
not ride in a buggy with any degree of comfort ; others 
who were necessitated to carry rubber cushions, hol- 
lowed out in the center, around with them. 

The objective symptoms revealed by examination 
through the rectum by means of the rectoscope or sig- 
moidoscope shows (when there is much enlargement of 
the gland) the latter organ protruding as an oval mass 
upon the front wall of the rectum. If inflammation of 
the gland coexists, there is either redness or lesion of 
the mucous lining of the bowel at that point. "We are 
also able by the same means to determine the amount of 
inflammation that exists in the seminal vesicles and 



173 

sigmoid-flexure. All of these are very important diag- 
nostic points, as relief of the prostate cannot be effected 
without first relieving the other organs mentioned. 

. By pressure upon the gland, through the rectum, may 
be determined somewhat the extent of the inflammatory 
state, which is usually reflected to the glans penis. It 
requires an experienced touch of the finger to determine 
whether this enlargement is due to a swollen inflamma- 
tory condition, or to indurated hypertrophy ; in fact this 
particular form of examination is seldom or never con- 
clusive. When the swollen enlarged condition exists 
it causes such tension upon the capsule surrounding the 
gland as to render the latter so tense and firm as to pre- 
vent the most skilled operators or physicians from detect- 
ing the difference between this condition and true senile 
hypertrophy. In the former case, both lobes of the pros- 
tate are usually about equally swollen and tender; but, 
though somewhat firm to the touch, they do not feel 
cartilaginous. The lobes of the gland appear more sym- 
metrical, and are not nodulated as they are in indurated 
hypertrophy and tuberculosis of the gland. 

The only advantage in examining the prostate per 
rectum, from a diagnostic point of view, is to determine 
the existence of the third lobe. This can only be accur- 
ately detected by means of the elongation of the urethra. 
In short, it requires much practical experience to be 
able to utilize rectal' examinations in differentiating be- 
tween true senile hypertrophy and swollen congested 
gland. 

The most satisfactory examination to determine the 
condition of the prostate with reference to acute, sub- 
acute and chronic conditions, is through the urethra 
and bladder, by means of the instruments devised spe- 
cially for the purpose by the author. As regards senile 



174 

hypertrophy, the easiest way to detect it is by means 
of a small, flexible, elastic, bulbous bougie. By passing 
this instrument slowly and carefully along the canal 
experience can detect its passing first through the mem- 
branous urethra, then over the triangular ligament and 
along the prostatic urethra, to the extent of 8 or 8y 2 
inches. Should it then enter the bladder without 
further resistance, we may conclude that it is not true 
senile hypertrophy; but should it meet still further 
resistance and show that the urethra extends as a some- 
what rough passageway, then we conclude that there has 
been formed a third indurated pathologic lobe which 
prolongs this canal to 9 or 9% inches. The next most 
satisfactory way of determining whether the disease be 
true hypertrophy or simple congested inflammatory 
enlargement is by means of the author's special cysto- 
scope, with which an experienced eye can detect this 
elongated urethra and formation of third lobe. 

These points are of special interest, and one should 
strive to perfect himself in diagnosing these conditions, 
as they are of marked importance in diagnosis, and more 
especially in prognosis; because the patient will almost 
invariably ask the physician if his case is curable, and 
how long it will take to effect a cure. 

Complications. The neck of the bladder invariably 
becomes involved, and is generally quite sensitive to the 
touch of an instrument or to the effect of acrid urine 
coming in contact with it. The inflammation is usually 
confined to a limited area of the mucous lining of the 
bladder immediately adjacent to the neck or base of the 
prostate, as illustrated in Plate XVIII. But in cases of 
long standing, attended with much congestion and inflam- 
mation of the prostate, the trouble extends and may 
involve the entire mucous lining of the bladder. And as 



175 

this condition of the bladder is the result of prostatitis, 
the latter must be relieved before any permanent benefit 
can be expected in treatment of the former. In fact, I 
have found that in the large majority of cases the little 
benefit that would accrue from the antiseptic solutions in 
washing the bladder is more than counteracted by the 
ill effects of passing an instrument for the purpose over 
an inflamed prostate. To avoid the irritation of the 
prostate by the instrument, the writer has devised means 
by which the bladder can be irrigated without passing 
any instrument over the inflamed surface of the pros- 
tate. 

Urine. The examination of the urine is of great 
value as an aid to making a correct diagnosis. The main 
points of interest only will be considered here. By 
casual observation one can note whether the urine is 
opaque or translucent; whether its constituents are 
flocculent or intermixed with the urine; or whether it 
precipitates to the bottom. The former condition indi- 
cates mucus or a muco-purulent admixture. "When it 
precipitates it implies a serious condition and calls for 
a thorough chemic-microscopic test; and then when the 
practitioner has had much experience, he may even by 
casual observation be able to determine its chief charac- 
teristics and its source. When it is slow in precipitating 
and is of whitish gray or reddish appearance, it indi- 
cates a muco-purulent nature ; when red it implies that 
blood is also present, and (especially if attended with 
irritation) that it is serious. A deep yellowish red at- 
tended with much irritation in voiding denotes an ad- 
mixture with bile. Especially is this true when there 
is but little or no deposit. Chemical examination, how- 
ever (when it is imperative to be accurate), is neces- 
sary. In fact, it is necessary to be accurate m every 



176 

instance; but what the writer wishes to convey is, that 
one with much experience, bearing in mind the above- 
mentioned characteristics, can detect bile without a thor- 
ough chemic examination. Should there be a grayish- 
white, granular deposit present in the urine when first 
passed, and not in very large quantity, it implies muco- 
prostatic origin. Should the quantity of deposit be 
much larger, and passes more especially at the end 
of voiding, and be mixed throughout the entire urine, 
and be more of a whitish than of darker gray (and espe- 
cially if this condition is periodical and it is voided the 
first thing in the morning), it is then pathognomonic of 
pyelitis or inflammation of the pelvis of the kidney, and 
implies either that the condition is now serious or even 
dangerous, or that it may soon cause serious complica- 
tions in the true parenchyma of the kidney. Often this 
condition exists, and by appropriate treatment the pel- 
vis is relieved of an immense mass of accumulated debris 
of this character; which indicates by its large quantity 
that it has been accumulating within the pelvis for a 
long time. Often I have had patients to state that they 
had voided a quart of this whitish urine, that was ex- 
tremely irritating; "burns like fire," as some expressed 
it. The pelvis of the kidney (as a matter of fact) could 
not hold a pint; and the large quantity that is passed 
is due to an admixture with the urine, that washes out, 
as it were, the pelvis, and gets rid of this accumulated 
mass. This mass should be chemically examined. It is 
evident to any intelligent physician, that, should this 
unhealthy mass of grayish-white, alkaline, earthy, phos- 
phatic debris thrown off from the pelvis become so 
abundant and so thick as to be rendered incapable of 
passing through the narrow constricted orifices of the 
ureters (especially when they are inflamed) it would 



177 

cause such pressure upon the true secreting kidney as to 
give rise to much pain and ultimately precipitate inter- 
stitial nephritis. The writer believes that this is the 
chief cause of Interstitial Nephritis or il Bright 's Dis- 
ease." Too much stress cannot be placed upon the 
above described condition; and especially when this 
characteristic urine is voided the first thing in the morn- 
ing, and in large quantity. Another important feature 
of this condition is that it very suddenly disappears; 
and the urine clears up, even in a single day or night. 
The deposit, however, may probably reappear the next 
or the third morning. The character of the epithelial 
cells also shows to a large extent, the source of unhealthy 
deposits in the urine. The writer has observed many 
instances where complications of the bladder and other 
organs coexisted with pyelitis. Large pavement epi- 
thelia (characteristic of the mucous lining of the blad- 
der), may be present. Small epithelia of similar char- 
acter are pathognomonic of pyelitis, and much more 
serious in character. 

The chemic constitutents of this whitish mass that 
accumulates in the pelvis and that passes off in large 
quantities, consists mainly of earthy phosphates and 
alkalies, that often cause the formation of calculi within 
the pelvis of the kidney, which at times become so large 
that it is impossible for them to pass through the ureters. 
Sometimes they pass from the pelvis down the ureter 
into the bladder and form a nucleus for the develop- 
ment of a stone there. The writer, many years ago, saw 
one case that had lingered for years, where an autopsy 
revealed the fact that the pelvis of the left kidney was 
entirely filled with a calculus that extended up into the 
calices; the stone was simply a cast of the interior of 
the pelvis. 



178 

There are various other alkaline deposits in the urine, 
such as sulphates, phosphates, etc., which are of minor 
importance, especially when compared with those already- 
mentioned. 

Mucus, pus, blood and other organic constituents 
characteristic of inflammation of the prostate as the pri- 
mary cause (and of the bladder and adjacent organs as 
sequels thereto) can easily be detected, and relieved by 
simply removing the cause. Albumen and sugar are 
often transient in the urine, and are of little signifi- 
cance; as most any nervous disturbance will cause pre- 
cipitation of either. "When albumen is persistent it calls 
for a thorough examination, to ascertain if it proceeds 
from interstitial nephritis. Urea (resulting from the 
elimination of proteids) when in excess becomes quite 
irritating; and in old men whose eliminative organs are 
somewhat impaired, an excessive amount of meat should 
be avoided. 

Urea results from the perfect combustion in the body 
of proteids. Imperfect combustion of proteids results 
in uric-acid. Ofttimes have I heard men say they are 
taking this or that medicine for "uric-acid" or "uric- 
acid diathesis." Uric-acid often results from lesion in 
an organ causing disturbance in its sympathetic gang- 
lion, that in turn so disturbs the vaso-motor system as 
to prevent thorough combustion of proteids. The more 
alkalies taken to remove this symptom, the more certain 
is it that these alkalies will combine with the uric-acid 
and form calcareous deposits within the joints or within 
the body, and ultimately give rise to serious, dangerous, 
and often fatal, results. 

Hyaline, waxy, and coloid casts are often mistaken 
for tube casts ; and pronounced indicative of interstitial 
nephritis, when such disease does not exist. 



179 

Urinary fever often results even where the most 
judicious means have been observed in treating patho- 
logic conditions of the prostate, bladder, or other of the 
urinary organs. In all lesions nature attempts relief 
by throwing out plastic matter and covering these sores 
or ulcers in order to protect them from the irritating 
properties of the urine. This plastic material being con- 
stantly bathed in mucus or urine, is soft and easily 
denuded or rubbed off the sore by instrumentation, in 
the efforts to apply remedies to cure these ulcers. Septic 
urine coming in contact with this abraded surface, after 
it has been denuded of its plastic coat, becomes absorbed, 
causing "urinary fever" as it is termed. The writer 
has devised a special remedy for use in such cases. It 
is a gummy, sticky ointment which is both septic and 
healing; and when applied to these ulcers, prevents the 
spreading of infection. 

Urea exists normally in the urine as a result of meta- 
bolism of proteids or of muscles. Five hundred grains 
are excreted normally every day. 

Urea greatly preponderates over the other constituents 
of urine,, and forms normally about one-half or more of 
the total solids; this can be increased or diminished by 
the amount of proteids ingested or the amount of phy- 
sical exercise taken. 

The solid products of the urine are mainly formed in 
the tissues where metabolism takes place ; and are elabo- 
rated in the liver, and finally separated and eliminated 
by the kidneys. 

During metabolism of the proteids in the tissues a 
certain amount of them, especially under excessive exer- 
cise, escapes complete combustion, thereby forming uric 
acid to the extent of .03 of 1 per cent normally. Uric 
acid often accumulates in large quantities under ab- 



180 

normai conditions, m many cases largely in excess of 
its normal proportion. Under abnormal conditions it 
also results from the breaking up of the nuclein of the 
cells and forms xanthin, which by oxidation is converted 
into uric acid. 

In a former chapter I mentioned the effect of the 
various purulent secretions accumulating in excess, and 
destroying the normal protoplasm of cells; whereby 
these cells were filled with fatty degenerate mucoid, 
coloid, and other deposits, causing degeneration of the 
kidney, heart, lungs, etc. But the nuclein of the leuco- 
cytes being oxidized by xanthin through the perversion 
of the vaso-motor system forms the chief source of uric 
acid sodiuu urate. 

Uric acid exists under a dibasic form — normal amor- 
phous urates, which are practically soluble; and acid 
urates existing in the form of rhombic crystals, which 
most probably circulate in the blood as a mono-natrium 
urate or in combination with some organic acid, or as 
acid sodium urate. 

For a more thorough and extended report upon the 
pathologic conditions of the urine, reference should be 
made to standard works on Urinology, as I am here able 
only to deal in a very cursory manner with the subject, 
and then only so far as pertains to the special diseases 
with which this book deals. 

Prostatic Calculi. There are certain concretions 
(prostatic calculi), that form in the prostatic follicles 
and ducts in adult life. Sir Henry Thompson, who has 
described them fully, reports that, "of one hundred 
prostates examined, these bodies were found in all of 
them." In younger subjects they are very small, and 
can be detected only with the aid of a microscope ; while 
in older prostates they can easily be seen with the nat- 



181 

ural eye. They are entirely distinct from renal or uri- 
nary calculi, and begin to form in some part of the kid- 
ney or the bladder and continue to develop, by accretion, 
until they reach considerable size. They most frequently 
form in the pelvis of the kidney, and after passing into 
the bladder become nuclei for the formation of much 
larger bodies. The concretions of the prostate are usu- 
ally small at first; but they gradually increase in size, 
and the writer has removed some as large as the end of 
his little finger. These latter fill the entire urethra; 
and the conditions are often erroneously diagnosed as 
enlarged prostate or stricture. Inflammatory conditions 
of the gland perverting the normal secretions, tend 
towards developing these bodies, just as a catarrhal con- 
dition of the pelvis of the bladder and cystitis produces 
urinary calculi. 

Owing to their extremely small size, they very rarely 
give rise to trouble in young men, although I have 
detected some as large as a pea in men only twenty-six 
years of age. In older men with swollen inflamed 
prostates, they act as foreign bodies pressing upon the 
different portions of the sensitive gland and give rise 
to marked irritation, which is manifested by frequent 
micturition, vesical tenesmus and pain in the region of 
the prostate, perineum, glans penis or fossa navicularis. 
They are usually rough upon their surface; and, when 
they develop to the size of a pea, often give rise to 
prostatic abscesses, besides obstructing the flow of urine. 

These prostatic calculi often become lodged in the 
small ducts of the gland at the entrance to the urethra, 
and give rise to excessive irritation in voiding urine. 
Many such cases have come to the writer, reported to be 
suffering from hypertrophy or enlarged prostate, who 
had been advised to have the gland removed. When 



182 

the writer succeeded in dislodging these concretions and 
causing them to escape through the urethra, the trouble 
was at once relieved. A skilled operator can easily detect 
their presence by means of the cystoscope. 




Figure XIX. 

Figure XIX shows specimens of these concretions, that 
were passed by a patient sixty-one years of age, with an 
exceedingly tender and irritable prostate, during the 
evening following a treatment by cataphoresis. The 
urine was passed into a porcelain vessel, and allowed 
to remain over night. On the following morning it was 
poured off, the residue adhering to the vessel. The ves- 
sel was then rinsed with clear water, and the residue 
scraped from the bottom of the vessel, and preserved. 
It was firmly glued together by a muco-purulent admix- 
ture, and was broken apart in pieces of different sizes, 
as shown. There was quite a large number of these 
pieces, weighing in all about a drachm. The large ma- 
jority of these were destroyed by experimenting upon 
them with the combined properties of different chemicals 
and electrolysis, in order to determine the agents that 
would be most active in their disintegration, and, at the 



183 

same time, the least irritating to the gland. The remain- 
ing pieces were pasted to a piece of dark paper and a 
photo engraving, or ' ' half tone, ' ' made from it, as illus- 
trated. 

Sympexia. In addition to the calcareous formations 
that are so often present in the ducts and follicles of the 
congested prostate, there exists occasionally a lumpy, 
gelatinous substance of a whitish or light red color, 
called sympexia. These bodies vary in size from that 
of a small pea to twice that size. They frequently be- 
come quite firm and provoke much local irritation of 
the gland and vesical neck, causing frequent and painful 
micturition, and even abscesses in the prostate, when 
they become too firm and large to pass off through the 
ducts. They have also been detected in the seminal 
vesicles, where doubtless most of them begin to form 
from pent up, unhealthy semen and the morbid secre- 
tions that result from the inflammatory condition of the 
vesicles. They no doubt assume their firmness in their 
tardy course through the prostate, where they mingle 
with the calcareous matter formed in the latter. 

They do not pass at regular intervals, seldom daily, 
and usually follow the emptying of the bladder or the 
discharge of fecal matter while at stool. I have noted 
some cases where they would pass once or twice a week; 
then not again for a month. "When they pass often, they 
are of lighter color and less firm than when they have 
been pent up in the gland for a longer time. Their 
presence causes great annoyance to many men, who mis- 
take them for semen. They may occur in any stage of 
prostatitis, in young, as well as older men. I have noted 
them more frequently in young men, leading a life of 
continence, or in middle-aged men with long standing 
prostatitis. 



184 

PROSTATIC ENLARGEMENT AND MELANCHOLIA, OBSCURE 

ORIGIN. 

Case 21. Bachelor; forty-eight years of age; weight 
one hundred and seventy pounds. He had practiced 
masturbation in early life moderately — never had gonor- 
rhea. Always lived in a small town and had been suc- 
cessful in business. Up to his forty-fifth year he had 
been in good health. About that time he began occa- 
sionally to pass sleepless nights, and gradually grew 
worse. This continued for about one and one-half years, 
when he became melancholy and despondent about his 
business. His brother had noticed, at times, mental 
aberration, and, . after consulting the family physician, 
decided upon placing him in a sanitarium. The patient 
tacitly consented to go, but on the evening before the 
day fixed for departure, he surreptitiously left his home, 
and wandered about from place to place for more than 
a month, when, upon inquiring for a physician, he was 
directed to me. 

He was very secretive as to his family and home, but 
talked very intelligently and freely about himself, his 
wanderings, habits and the foolish things he had done; 
this had induced his brother to think he was verging 
upon lunacy, of which he himself was cognizant. The 
subjective symptoms pointing to disease of the gland 
were quite meager, and he was loth to submit at first to 
an examination. 

He, with two other prominent men of his town, was 
appointed to investigate the stealing of some cattle. The 
evidence was quite clear and pointed directly to the 
accused. On the day before the trial the patient conceived 
the idea that he must come to the rescue of the culprit 
and protect him at all hazards. A life-long friend of 



185 

his who also knew the damaging evidence also spent the 
night with the accused man at the latter 's house. Real- 
izing that he and his friend were the only ones who 
could convict the accused, so obsessed was he by the 
idea of saving the latter that he could not rest ; patrolled 
the house all night long, and actually tried to kill his 
friend. This aberration of mind resulted from prostatic 
troubles, and disappeared after the disease was cured. 
There have been many similar cases brought to my 
notice, where the party affected also endeavored to kill 
his best friend, on account of mental aberration, super- 
induced by this reflex prostate irritation causing dis- 
turbance, first of the prostatic ganglion, then of the 
genito-spinal center, and ultimately persistent disturbance 
of the reasoning faculties of the brain. 

So many of these cases of mental aberration arising 
from reflexes of abnormal conditions in the pelvic organs 
have been brought to the notice of the writer that he 
believes that a large proportion of men incarcerated in 
lunatic asylums are brought there primarily by the 
effect of these lesions. 

The urethra was very sensitive throughout its length, 
and, in the prostatic part, quite painful at the touch of 
the flexible bougie. The gland protruded into the rectum 
to the extent of flattening fecal discharges. Digital 
pressure upon the prostate through the rectum caused 
an aching pain in the region of the perineum and 
bladder. 

Granulated inflammations throughout the prostatic 
urethra and neck of bladder were prominent symptoms. 

His recovery was rapid, and at the end of the first 
month he was sleeping normally, and his mind restored. 
It was at this time, after his normal mind had been 
restored that the patient gave a long and detailed his- 



186 

tory leading up to the mental aberration, and the at- 
tempt to kill his best friend. After being restored to 
health he was loth to return home, fearing a recurrence 
of his trouble, besides dreading the incident publicity. 
The treatment was continued two months to reduce the 
enlarged gland. Kecovery was permanent. 

PROSTATITIS, VESICULITIS, RECTAL ULCERATION. 

Case 22. Bachelor; aged forty-four, had fir^t attack 
of gonorrhea at twenty-two, which was quite severe, and 
continued for several months, finally terminating in 
gleet, and, as he thought, stricture. He had several mild 
attacks of acute gonorrhea, the gleet continuing during 
the interim. He had been treated several times with 
sounds for stricture. He suffered constantly with his 
back and limbs, and had made several trips to Hot 
Springs, Ark., for multiple arthritis. He was always 
benefited by the Hot Springs baths, but the pains would 
recur in from four to six months thereafter. Upon ex- 
amination I found the urethra slightly tender an inch 
back of the meatus, and upon the lower surface. The 
other portions of the canal were healthy, except the 
prostatic, which was very much inflamed. There was 
no organic stricture, nor do I think he ever had any, 
though he had been advised several times to submit to 
an operation for such. The long standing granular 
inflammation of the prostatic urethra, with the enlarged 
gland, had encroached upon the caliber of the canal at 
that point, narrowing it and obstructing the free flow 
of urine, at times, when it was acrid ; and also the free 
entrance of an instrument to the bladder. 

The gland was swollen as determined through the 
urethra and rectum, and painful upon pressure; this 



187 

pain was reflected to the glans penis. Both lobes of the 
gland were equally involved. Immediately opposite the 
prostate, upon the front rectal surface, was an elliptical 
ulcer an inch and one-half long and three-fourths of an 
inch wide. The vesicles were tender, and the rectal 
mucosa opposite them was inflamed and thickened, but 
not abraded. After several examinations of prostatic 
expressions, gonococci were finally discovered. 

Recovery was rapid ; no return of pains since his dis- 
missal, 10 years since. 

GLANDULAR ENLARGED PROSTATITIS, CYSTITIS. 

Case 23. Bachelor; aged sixty-nine; robust, had led 
an outdoor life. He had gonorrhea in early manhood, 
and quite a number of subsequent attacks. He had suf- 
fered with his bladder and prostate for fifteen years, 
and had been treated by massage of the gland, sounds, 
irrigation and cautery applications to the deep urethra. 
He had just left a genito-urinary specialist when he con- 
sulted me, after being treated with large sounds daily 
for six weeks. 

He was suffering with frequent and painful urination, 
voiding it on an average every thirty minutes during 
the day, and hourly at night. The urine was of light 
color, laden with mucus, pus, urea and of ammoniacal 
odor. I did not attempt an examination at this stage, 
but made applications to allay acute symptoms. Rest 
in bed was enjoined. After three days the acute symp- 
toms had been allayed when an examination revealed a 
congested glandular enlargement of the prostate, pros- 
tatic urethritis, and cystitis. He had been washing out 
the bladder with boric acid daily, which I had him dis- 
continue. 



188 

He was treated similarly to the patients before men- 
tioned, after acute symptoms had been allayed. His im- 
provement was rapid, and at the end of the third month 
the urine was cleared up, and voided about four times 
during the day and once through the night. He would 
occasionally pass the night without having to get up ; 
then again he would have to pass his urine twice in the 
night. After his return home he continued to improve 
until conditions were about normal for a man of his age. 

Five years later he began having some difficulty in 
starting the flow of urine; then periodical hemorrhages 
would occur. By cystoscopic examination I detected a 
small vegetative growth, almost the size of the end of 
one 's small finger, attached to the lower part of the neck 
of the bladder. It was highly vascular and would bleed 
freely when touched. Its free extremity floated about 
the vesical orifice and acted as a valve that at times shut 
off the flow of urine. Six months afterwards hemorrhage 
again recurred. Cystoscopic examination revealed a 
short pedicle of the tumor with an abraded surface. 
This was promptly healed and he has had no further 
trouble with it. 

Similar patients have come under my care, suffering 
with vegetative, polypoid, vascular or semi-fibroid tumors 
protruding from the base of the prostate into the blad- 
der, which act as a valve to obstruct the passage of 
urine. Some of these cases have yielded readily to 
treatment; others have been persistent and unyielding, 
with a continued recurrence of periodical hemorrhages. 
Polyp oids at the neck of the bladder are extremely diffi- 
cult until after the gland has been cured. Besides, 
their presence complicates both the prostate and the 
bladder, and is often attended by serious and even dan- 
gerous sequelae, and causing the bladder to become 



189 

filled with blood. The bleeding is quite difficult to arrest. 
Cases of profuse hemorrhage should always be regarded 
with suspicion, and especially if the hemorrhage recurs 
two or three times. Those that have proven so rebellious 
to treatment have been of fibrinous character. 

CHRONIC ENLARGED PROSTATITIS, VESICULITIS, AND CYSTITIS. 

Case 24. The patient was seventy-two years of age, 
costive, constant pain in back and perineum, the latter 
necessitating his using a rubber cushion, hollowed out 
in the center, to sit upon. The urine was alkaline, 
heavily laden with mucus and pus, one-fifth of which 
would be a semi-solid mass upon settling ; and, at times, 
strongly ammoniacal. Fecal matter passed in lumps or 
flattened. He had been treated by the usual methods, 
with sounds and irrigations. The prostate was very 
large but not tender upon pressure. The vesicles were 
similarly affected. The prostatic urethra was quite 
tender. He had a constant urethral discharge. He was 
given temporary relief and then returned home, where 
he remained two months, then came back for further 
treatment. 

He was now able to ride about in his buggy, dispensed 
with his cushion, but was still unable to evacuate his 
bowels without the use of medicines. There was only a 
trace of sediment in the urine, and the urethral dis- 
charge was scarcely perceptible. He remained under 
treatment four weeks at this time. The prostate was 
reduced almost to normal, the urine had changed to an 
acid reaction, free from sediment, and with specific 
gravity of 1022. He was comparatively free from pain. 
He again returned home and I did not see him for two 
years. He had been comfortable during all this time, 
with the exception that he occasionally had quite copious 



190 

and irritative urethral discharge. Upon examination at 
this time I f onnd the prostate, about normal in size and 
non-sensitive. The vesicles were tender, and the rectal 
mucosa surrounding them thickened, and unduly red. 

A detailed account of the methods used in his last 
treatment appears in the supplementary volume. 

I have heard from him several times since he went 
home, and he tells me that he is now quite well, has had 
no return of the discharge and rides on an average of 
fifteen miles a day on horseback. 

CONGESTED GLANDULAR ENLARGED PROSTATE, URETHRITIS, 
MULTIPLE SYNOVITIS. 

Case 25. Married; good physique; aged forty-eight, 
two children, negative history. He had been confined 
to bed for four or five months prior to seeing me, with 
polyarthritis, including the shoulders, wrists and lower 
limbs. He had been dosed with all the rheumatic reme- 
dies about which the profession have any knowledge, 
with only temporary relief. There was little or no swell- 
ing of the joints, but moving them caused much pain 
and creaking. He was unable to dress himself, but was 
able to walk about. The prostate gland was very ten- 
der, both through the urethra and rectum. There was 
no apparent urethral discharge, though the prostatic 
part of the canal was very sensitive. He began im- 
provement after the first week, and the stiffness and pain 
in the joints left him at the end of three months' treat- 
ment of the prostate and vesicles. 

ENLARGED GLANDULAR PROSTATITIS, CYSTITIS, PROSTATIC 

CALCULI. 

Case 26. A mechanic, aged sixty-two, married. No 
gonorrheal history. He had never taken a drink of 
alcoholic liquors nor used tobacco in any form. Up to 



191 

his fifty-fifth year he was free from any symptoms of 
disease of the bladder, prostate or kidneys. About that 
time he began passing urine more frequently than 
normal and it became noticeable when he was chilled, 
or his feet were wet, that it irritated his bladder, which 
necessitated him to evacuate his bladder more frequently, 
both day and night. He resorted to the ordinary domes- 
tic remedies with temporary relief. Subsequently he 
began, during paroxysms of dysuria, to pass some blood 
at the cessation of the flow. The hemorrhage became 
more marked in time, and was accompanied with pain 
in region of the perineum and bladder. All symptoms 
increased in severity, compelling him to seek relief. He 
then consulted a genito-urinary specialist, who began 
the use of sounds. This aggravated his symptoms. He 
next underwent the Bottini cautery operation, which 
was followed by profuse hemorrhage on the second day 
to such an extent that he became almost bloodless. The 
hemorrhage was finally controlled and he had a sIoav 
tedious recovery. This was followed by some temporary 
relief, when he relapsed into still worse condition than 
before the operation, and was confined to his bed for 
several weeks with some form of fever. On recovering 
from the fever he came to me for treatment. After two 
weeks' treatment his condition was so much improved 
that he returned home. 

He was very much emaciated, anemic and voiding 
urine on an average, during the day, every fifteen min- 
utes, and at night about every forty minutes. He suf- 
fered with constant pain in his back. The urine was 
strongly alkaline and contained a heavy sediment of 
mucus and pus, of ammoniacal odor, and occasionally 
tinged with blood. 

He returned to work handling heavy machinery, and 



192 

I did not see him again for three months, when he re- 
turned with the same symptoms somewhat aggravated. 
Treatment was again resumed with variable results: at 
times there would be much improvement, then he would 
relapse into his former condition. During all this time, 
however, he was continuously at work carrying heavy 
machinery. One day following a treatment of urethral 
cataphoresis to the prostate he passed quite a quantity 
of prostatic concretions, varying in size from a pin point 
to a mustard seed, as illustrated by Figure XIX. 

He finally became discouraged with my treatment and 
sought the advice of another physician. 

I did not hear anything further from him; but about 
one month thereafter I incidentally noticed an account 
of his death in a hospital as the result of an operation. 
I never learned the nature or purpose of the operation. 

Case 27. Was similarly affected to the foregoing. 
He, too, had been operated upon with the Bottini cautery 
and by the same physician. On the fifth day after the 
operation he had a violent hemorrhage which lasted 
several hours, rendering him unconscious and almost 
pulseless. The hemorrhage was finally controlled after 
many hours' work by the physician. This patient was 
treated in a similar way to the preceding one, and im- 
proved more rapidly. In fact, he was so far relieved of 
irritation about the bladder and prostate that I thought 
at one time he would ultimately recover; but he, too, 
had some operation performed upon his bladder or pros- 
tate, and I have never since learned the result. 

In these cases there were no indications for the Bot- 
tini operation ; and I do not hesitate to state that it was 
made, as I have known others to be made, in an em- 
pirical manner, without reference to the exact diagno- 
sis of the condition of the prostate. The bleeding, as 



193 

result of the operation, relieved for a time the congested 
state of the gland, and it, together with long rest in 
bed, relieved temporarily the inflammation, but at the 
expense of the irreparable injury to the gland, as denoue- 
ment of the cut and cicatrix. The only indication where 
such an operation is at all justifiable is in those cases 
where an obstruction forms at the neck of the bladder 
by way of a firm fibrinous band; or, in other words, 
where there is a development of the third or middle lobe 
of the prostate. When the latter condition exists to 
such an extent as to obstruct the flow of the urine, it 
may be severed with little danger to life, either direct 
or indirect, and especially after the case has been pre- 
pared for such an operation by the reduction of acute 
congestion and inflammation. 

PROSTATITIS, VESICULITIS, PROSTATIC URETHRITIS, SYMPEXIA, 

HEMIPARESIS. 

Case 28. Merchant ; married ; aged fifty-five ; gonor- 
rheal history. He had been treated several times by 
means of sounds, massage of the prostate, internal medi- 
cation, etc. 

Examination showed an enlarged and inflamed pros- 
tate, perivesiculitis and inflammation of the neck of the 
bladder. The right leg became impaired and grew 
gradually worse ; then the arm and hand on that side 
were also affected after a year's existence of the trouble. 
There were various shaped lumps of a tenacious char- 
acter that passed from the urethra, at times following 
the emptying of the bladder in the last efforts to expel 
its contents and again on evacuating the bowels when 
costive. There was a perverted sexual propensity, often 
a premature discharge of semen during sexual congress, 
then a^ain a condition of inertia. 



194 

The gland was enlarged and inflamed, the rectal 
mucosa, around the vesicles, was thickened and unduly 
red. The prostatic urethra was very tender. The lumpy 
discharges (sympexia) consisted of mucus, calcareous 
matter and disintegrated semen. 

He was anemic, emaciated, costive, and dyspeptic. 
Complete recovery followed five months ' treatment. The 
lame leg was somewhat sluggish and heavy for a year 
afterwards, but finally regained normal condition. 

Case 29. J. B. C. ; age 34 ; single ; no marked heredi- 
tary tendencies, father and mother both living to old 
age; his life up to the sixteenth year was uneventful; 
at that time he had gonorrhea, which continued from the 
acute, sub-acute and chronic stages throughout several 
years. Finally he consulted a physician who began using 
sounds; acute cystitis followed for about three weeks. 
Went to Hot Springs in 1903. Sounds were used and 
other similar local treatment given with massage of pros- 
tate through rectum. This resulted in complete reten- 
tion of the urine, necessitating the use of the catheter. 
This was followed by an abscess of the prostate which 
ruptured through the prostatic urethra. During this 
time he was compelled to evacuate the bladder three to 
five times during the night and almost hourly through 
the day. He went to Battle Creek, Michigan, in 1906, 
where he remained two months; no relief; back to Hot 
Springs in 1908, when he began having trouble with his 
heart, marked regurgitation and pulse varying between 
98 and 116 ; unable to walk upstairs ; in 1899 he was 
directed from Hot Springs to consult the writer by Dr. 
Walker. Physical examination resulted in discovering 
acute prostatic urethritis, swelling and parenchymatous 
enlargement of the gland, vesiculitis, cystitis, valvular 
insufficiency and endocarditis, acetonemia very marked. 



195 

First efforts were directed toward relief of the acute 
symptoms, followed by treatment of the cystitis and 
vesiculitis, then to reduce the prostate. Relief of the 
heart symptoms immediately followed the removal of 
the other abnormal conditions. 

His feet and legs were swollen up to his knees, neces- 
sitating the wearing of slippers. Progress in this case 
was steady and uninterrupted toward recovery, which 
was complete at the expiration of four months, when he 
was discharged. He returned on June 22, 1912, antici- 
pating marrying, when thorough examination failed to 
disclose any organic lesion and he now reports himself 
as well as he ever felt in his life. 

Case No. 30. A. B. T. Farmer ; age 38 years ; weight 
135 pounds; six feet tall; Kansas; mother still alive; 
father died of Bright 's disease (so-called) ; negative his- 
tory ; first troubled five years ago with constipation and 
headache; then became prostrated, very weak, nervous 
breakdown, constipation, and "rheumatism," legs swell- 
ing to knees ; some days could not walk three blocks with- 
out sitting down to rest; better at other times; necessi- 
tated to void urine once, and often twice during the 
night ; gradually growing worse ; urine filled with urates 
and calcium phosphates; nocturnal emission alternate 
nights, and often two during same night. Was examined 
by two doctors who pronounced his ailment heart dis- 
ease and consumption; prostate and rectum not exam- 
ined; sent to Boulder (Colorado) Sanitarium, where he 
remained three months; little improvement; still weak, 
nervous, sleepless, and troubled with his heart ; swelling 
in limbs passed off except in ankles; went to Texas for 
change of climate, result same ; went to Hot Springs, 
Arkansas, and was treated for seven weeks; grew worse 
all the time; was then sent to the writer, who, upon 



196 

examination, found him suffering intensely and daily 
with headaches, backaches, difficulty in breathing, in- 
somnia, and very nervous and restless; pulse 110-115, 
very weak; blood 70 — acetonaemia, mentally dull, and 
loss of memory very marked ; extremely constipated ; felt 
numbness all below waist and tingling sensations in 
calves of legs and in his feet; pain over the hip on left 
side, and in back of neck; tingling in tips of fingers, 
more noticeable on right than on left side; feels like 
needles sticking in hands. Physical examination revealed 
ulceration at neck of bladder and swollen prostate ; three 
overticula, and sigmoiditis. Treatments were given to 
relieve the local conditions described, and improvement 
was marked. Discharged three months later, sound and 
well, and has remained so ever since. 

Case 31. W. A. G., age 48 ; married ; three children ; 
negative history; no hereditary tendencies. 

Up to twenty-fourth year in comparatively good 
health. Then began declining, alternating with periods 
of recuperation. He began having a hacking cough, 
with little or no expectoration at first. This continued 
gradually to grow worse until, in his forty-second year, 
it became quite aggravated. At that time he began void- 
ing urine very frequently, which his physician claimed 
was caused by "uric-acid diathesis," and began dosing 
him with alkalies; some temporary relief. Two years 
afterwards he began growing worse, until his urine 
"stopped on him." Catheter was used for several 
weeks. Two physicians had examined him by that time, 
and pronounced his trouble due to tuberculosis of the 
prostate, and he was treated by means of serum injec- 
tions for its relief. His condition gradually grew worse 
until he was sent to the writer by one of the attending 
physicians. 



197 

Physical examination revealed parenchymatous, 
swollen inflammation of the prostate and neck of blad- 
der, with slight rectal complications. The urine was 
loaded with alkalies, phosphates, and was of an ex- 
tremely irritating character with ammoniacal odor. This 
kind of urine is always exceedingly irritating. Relief 
of the local prostatic trouble relieved all the other symp- 
toms with which he was suffering. On the subsidence 
of the acute inflammation of the prostate, the vesical 
neck, and bladder, on alternate days, there passed from 
the pelvis of the kidney three ounces of a whitish gran- 
ular mass that precipitated to the bottom of the urine. 
At times there were four to five ounces of this whitish 
urine voided. On the next day or the second day there- 
after, the urine would again clear up and be almost 
entirely normal. It has puzzled many physicians to 
know, not only the nature of this condition of the urine, 
but the source from which this whitish or (often) gray- 
ish white mass would come. It puzzled the writer for a 
long time, until he finally demonstrated beyond ques- 
tion the source of it. It is generally very irritative, 
and patients speak of it as "burning almost like fire," 
when voided. . 

Marked relief from the cough, which had by this time 
become so excessive that his chest was extremely sore and 
painful; although expectorating but very little. He 
suffered at times with indigestion. Having some symp- 
toms of tape-worm, I gave him treatment therefor, when 
he passed one twenty-four feet in length. Immediate 
relief of his cough ensued. His indigestion was entirely 
relieved, and he was restored to permanent health. 

Case 32. B. K. J. is a very interesting case, as well as 
an instructive one, because of his age, of the many seri- 
ous troubles from which he has suffered, and the remark- 



198 

able recuperative power which has enabled him to with- 
stand the various pathologic lesions that have existed for 
so many years, notwithstanding the various efforts of 
physicians to relieve them. Aged 82. Forty years ago 
he was treated for tuberculosis, having hemorrhages. 
He rallied from this, and was next treated for ' * Bright 's 
disease," then for chronic enlarged prostatitis, next for 
true hypertrophy, and finally for interstitial nephritis, or 
' ' Bright 's disease " as a positive diagnosis, on account of 
puffy swellings under the eyes, weak heart, extreme pros- 
tration upon walking, and copious flow of urine. Twenty- 
five years ago he was operated upon in the rectum, hav- 
ing the "American operation" as it was termed, per- 
formed. Thereafter he was never free from extreme 
constipation, necessitating the taking of medicine or 
using enemas all the time. The result of the operation 
was shortening of the tunics of the rectum, causing a 
constant irritation and dragging sensation therein, from 
which he was never entirely free. 

Examination revealed parenchymatous enlargement of 
the prostate, cystitis and vesiculitis. These were allayed 
in rapid succession, the puffiness under the eyes disap- 
pearing, strength improving, and he was able to retain 
urine seven hours. 

Examination revealed ' ' py-ro-sak, " which was re- 
moved, and since then he has never had to take another 
dose of medicine for the evacuation of his bowels. As 
it now stands this man is good for ten years more, unless 
some unforeseen circumstance should arise; as he is as 
near in a normal condition, with reference to all vegeta- 
tive organs, as any man of his age that I have ever seen. 

Case 33. J. B., age 81, married; several children; 
negative history. For fifty years he was a traveling 
salesman, then discontinued. Twenty-five years ago 



199 

operated upon by the " American operation. " He had 
suffered a sensation of drawing, as though of shortness 
of the lining membrane, as the former case, but not so 
marked. This gentleman was slightly constipated. Oper- 
ation for overticula removed him entirely of his consti- 
pation; he has not had any trouble of this kind since. 
He suffered slightly from sigmoiditis, but it yielded 
readily to treatment, notwithstanding his age. His 
heart's action greatly improved after this operation, and 
he has prospects of an extended old age of fifteen or 
twenty years, regardless of the fact that the rectum 
and prostate had each suffered the ill-effects of bad prac- 
tice ; the latter especially, from treatment by a copper 
electrode, setting up prostatitis, and considerable puru- 
lent discharge, as well as frequent micturition. The 
case yielded remarkably well, considering the age of the 
patient; he has been dismissed practically well, or as 
much so as a man of his age could expect, and walks 
with the elastic step of a boy. 

Case 34. L. W. L. From Pennsylvania; age 53 
years ; railroad man ; married, one child ; mother died of 
kidney trouble ; father of dropsy at advanced age, having 
had diabetes for fifteen years before his death ; had 
gonorrhea at 21 years of age ; ten years ago stomach 
began troubling him, and constipation followed; then 
marked indigestion ensued and he could not take any but 
liquid food with any degree of impunity, and even this 
was attended with marked accumulation of gas in stom- 
ach and bowels; large doses of saline cathartics and 
purgatives required to give operation of bowels; finally 
began the use of glycerine suppositories, one to five 
daily, causing considerable irritation of prostate and 
bladder ; up through the night at least five times to void 
urine, and much oftener during the day ; eight years ago 



200 

began to lose the use of lower limbs, especially on left 
side ; would drag left leg, and in going up stairs unable 
to raise same. Two physicians diagnosed trouble as 
" locomotor ataxia," and he had been treated therefor 
ever since, gradually growing worse. Both limbs swollen 
from knees down. Stinging, burning, itching sensation 
on inside of left leg, requiring intense rubbing to allay 
had retention of urine twice, and always hard to start 
constant residual urine of from six to eight ounces 
excessive urea, trace of albumen and sugar; urine alka- 
line, hyaline and colloid casts. 

Physical examination revealed ulcerated surface 
throughout prostatic urethra, and also three inches inside 
of bladder. All around the neck of the bladder and in 
the prostatic urethra there was a considerable quantity 
of proud flesh or vegetative growths almost occluding the 
canal, bleeding freely upon touching with instrument; 
devoid of acute sensation; gland slightly swollen. Two 
overticulas were removed. Sigmoid ulcerated through- 
out with marked diminution of lumen. Remedies were 
directed towards allaying of acute sensation, then re- 
moval of proud flesh in urethra and bladder, when urine 
again passed more naturally with less residual urine 
within the first two weeks ; treatment continued, avoiding 
the exciting of acute irritation at any time. At the 
expiration of six weeks he was enabled to eat much 
better, with less disturbance in digestion. After two 
months returned home, where, he remained for six weeks, 
improved very much. A letter stated, ' ' I have improved 
more since returning home than while under treatment, 
yet, for the last two weeks I feel that I have about been 
at a standstill, or slowly receding to my former con- 
dition. Must I return •? ' ' He returned and remained six 
weeks, 



201 

He had gained up to this time ten pounds in weight, 
and had improved in general condition, and especially 
with reference to his defective power of locomotion, 
which had evidently arisen from sub-acute myelitis. He 
was also passing (on alternate days) a whitish, granular 
urine which was very irritating, and would as he 
claimed, "burn almost like fire." The next day, there 
would follow a straw colored, almost natural discharge. 
This is characteristic of pyelitis, and it was a long time 
before the writer ascertained the source of this whitish 
substance that precipitates at the bottom of a glass. 
Sometimes this may fill the vessel one-third or one-half. 
This whitish granular urine comes from the pelvis of 
the kidney . Certain remedies and treatment given in 
such cases (which will be subsequently thoroughly eluci- 
dated) caused cessation of the acute inflammation of the 
ureter and a relaxation of these organs, enabling this 
mass to pass from the pelvis down into the bladder. 
Many mistake this for " Bright 's disease," or interstitial 
nephritis, but it rather indicates a continuation of the 
inflammation from the bladder up the ureter to the pelvis 
of the kidney. 

This man remained six weeks longer, when he re- 
turned home a sound, healthy man — has remained so 
ever since, attending to all of his duties, and reports in 
perfect health. 

Case 35. S. J. Age 47 ; married ; no children ; dark, 
swarthy complexion ; thin, emaciated and tongue heavily 
coated ; no appetite ; extremely costive ; temperate in 
habits; hard worker, having control of many men. Up 
to nine years previous hereto was in perfect health; 
trouble began with indigestion and accumulation of 
gases, stomach and bowels both distended after meals; 
this continued until he was forced to consult a physician, 



202 

who treated him first with digestive, then laxative reme- 
dies until two or three quarts of strong mineral waters 
were required to produce defecation, which would pass 
in the form of small lumps, attended with considerable 
quantities of thin, watery fluids; the passage being 
mainly of liquid nature. Physical examination revealed 
slight prostatic enlargement with occasional frequency 
in voiding urine, but with no particular pain, although 
the patient noted that it had become more difficult to 
start the flow and evacuate the bladder. On examina- 
tion his rectum was found to be extremely flaccid, and 
devoid of acute sensation and filled with a semi-liquid 
mass of fecal matter. The sigmoid flexure was so 
tightly closed by stricture that the largest instrument 
that could be passed was about the size of a No. 12 
bougie. It was also ulcerated and a thick muco-purulent 
mass was being constantly exuded from the bowel. The 
patient himself could easily detect the passage of the 
bougie through the strictured sigmoid. He had been 
thoroughly impressed with the idea that all that was 
necessary to get relief was to find some physician who 
could give him some special remedy suitable to his case ; 
and thoroughly imbued with this idea he had changed 
from one doctor and treatment to another, during all the 
nine years, remaining from six to twelve months with 
each, saying that he had been anxious to try all the 
different Apathies" in his effort to find the special 
remedy. The last had been an osteopath, who benefited 
him physically more than any others, yet gave no relief 
to his typhlitis, indigestion and constipation. Twenty 
years prior to taking this treatment he had been rup- 
tured, and had been treated by a process that had closed 
the opening, and he had gone without a truss for more 
than ten years, but the rather violent manipulations of 



203 

the osteopath had again ruptured him, which was the 
most objectionable feature of this treatment. After hav- 
ing been the rounds with the "pathies" he was on the 
verge of consulting a Christian Scientist when he met a 
railroad man whom the writer had cured of a similar 
trouble some two years before, and who induced him to 
consult me. 

Treatment of this case was begun by local applications 
of a mild nature with cataphoresis to the sigmoid. Re- 
lief followed very slowly, but he was persistent in con- 
tinuing from month to month. He was so improved 
after six months that he was no longer obliged to use 
purgatives. Treatment was continued for twelve months, 
stopping for short intervals, when, as he himself says, 
he was entirely restored, and feels as strong and well 
as at any time in his life. 

After this man had discontinued all treatment for a 
year, he returned, stating that he had another trouble 
about which he wanted to consult me. He had no 
trouble with his bowels ; they were moving regularly, his 
digestion was perfect, and the only symptom now was 
that when he awoke in the morning he felt as though 
he was completely exhausted, and that he absolutely had 
had no rest. He ate well, he slept all night, retired early, 
and he could not understand why his sleep was followed 
by depression. Examination revealed a "py-ro-sak" 
very high up, which, being removed, relieved instantly 
all of his disturbance at night, and he had perfectly 
normal sleep. This condition continued for four months, 
when he returned stating, "I am sure there is another 
one of those things, as I am getting back into the same 
state that I was when you removed that last one." I 
removed a second, then a third ; and he is now completely 
relieved of every symptom of abnormal condition. 



204 

Case 36. Age 51 ; married ; chronic glandular prosta- 
titis, cystitis, vesiculitis, gonorrheal metastasis. Con- 
tracted gonorrhea at the age of 26, which lasted six 
months, and was followed by acute prostatitis, urethritis, 
cystitis. He suffered with periodical exacerbations for 
three years, subsiding in a form of gleet, from which 
he occasionally had a slight discharge, or gluing together 
of the meatus. There were no marked indications of 
prostatitis, inflammation of the bladder, or any other 
trouble, until his forty-fifth year, when he began having 
attacks of what he called rheumatism, in his shoulders 
and back of neck, and occasionally in his back. There 
was an impairment of his left limb, by way of a heavi- 
ness, which necessitated a dragging of this limb, and 
he was unable to lift it as easily as the other. Some 
days it would be better, other days worse. Otherwise, 
health good. He was an active business man. Two 
years prior hereto he began to have excessive pains in 
back of neck and shoulders, extending to his fingers. 
Occasionally there would be a tingling sensation down 
the arm to the fingers, and he was unable to hold a 
pen to write. He noticed, about this time, too, that he 
was unable to shave himself. The pain grew so intense 
in back of neck that he could not sit in a barber's chair, 
with any degree of comfort, to be shaven. His digestion 
was good, bowels regular, weight normal, and usually 
slept well. He had been treated by some of the best 
physicians, with various kinds of medication, including 
the different preparations of coal tar, salicylates, etc. 
He had been treated by a nerve specialist, who applied 
electric currents to his spine, limbs and arms. At times 
this was followed with temporary relief ; yet each month, 
for a year, he had noticed he was worse than the 
previous one. 



205 

An examination revealed cystitis, prostatitis and vesi- 
culitis of chronic nature. The gland was somewhat en- 
larged — swollen — from long standing low grade of 
inflammation. There was no acute tenderness of the 
parts, but a cellular infiltration of the rectal-mucosa in 
the region of the prostate and vesicles. 

Chemical and microscopical examination of the urine 
and prostatic secretions revealed epithelial cells of 
squamous and columnar variety; also debris of cocci, 
which indicated additional involvement of the bladder, 
prostate and seminal vesicles. 

At this time, too, there began passing considerable 
masses of brownish white admixture from the pelvis 
of the kidney. This mass appeared on alternate days 
at first; then on the fourth or fifth day, until finally 
it disappeared altogether. I did not see him again for 
six months, when he reported that he had in the interval 
been quite well and had not had any symptoms of his 
trouble. 

Four years thereafter he again consulted me, stating, 
"As you cured me of my former trouble, I would now 
like you to cure another trouble that has been greatly 
annoying me. I began having paroxysms of fever about 
a month ago. At first they would begin about 4 P. m., 
and last two or three hours. They would leave me 
somewhat depressed, but I would be able to attend to 
business the following day. These attacks continued to 
grow in severity, and fever became so excessive as to 
reach 103 late in the afternoon, and I also suffered with 
pain in the left side. This would gradually wear off 
during the night, as defervesence occurred. From da}^ 
to day the fever and pain continued to grow in severity 
until it was continuous. It was less in the morning than 
in the afternoon but would never entirely subside." 



206 

Physical examination revealed ulceration and stricture 
of the sigmoid-flexure. He was also troubled with con- 
stipation and voiding of lumpy, hard, fecal matter. Im- 
provement in this case was slow and long drawn out. 
It was about two months before the fever entirely dis- 
appeared, and the pain was relieved; but he continued 
the treatment at irregular intervals for over twelve 
months before he was finally discharged cured. Since 
then he has had no recurrence of any symptoms. 

Case 37. Married ; age 56 ; chronic glandular pros- 
tatitis and vegetative growth at neck of bladder ; profuse 
hemorrhage of bladder. This man had been suffering 
with frequency of voiding urine for three years prior to 
seeing me. It first came on in a mild form, with occa- 
sional exacerbations. Finally, he consulted a physician, 
who was very prominent, highly educated, and thor- 
oughly well up in his business, except in the treatment 
of this special trouble. The patient began using sounds, 
gradually enlarging them until he reached 26 F. The 
patient seemed to improve some after the acute symp- 
toms had been allayed by this treatment. On November 
4, after having used the sound, he noticed that he was 
passing blood. He went to see his physician, and found 
that the bladder was practically filled with blood. The 
physician tried to stop it by astringent irrigations, but 
was unable to control the hemorrhage, and the patient 
was sent to me for treatment. On his arriving, I found 
the bladder distended and filled with clotted blood. The 
patient was very pale and very weak from the effect 
of the loss of so much blood. I immediately evacuated 
the bladder, taking two hours to accomplish it. During 
this time there was constant hemorrhage, which necessi- 
tated my entering the bladder with a cystoscope to 
ascertain the source. I found a vegetative growth at- 



207 

tached immediately to the back of the prostate. This 
was bleeding very profusely. The hemorrhage was con- 
trolled for the time being, and he was given remedies 
to use at his home. He left and was gone four months 
with little or no trouble from his ailment; he again 
returned, having a slight hemorrhage. Cystoscopic 
examination revealed another vegetative growth, at- 
tached to the prostate by the side of the pedicle of the 
first growth. After the hemorrhage was again con- 
trolled, he again left for home in good condition, having 
been given a remedy to use himself, in controlling any 
hemorrhage that might eventuate. He was finally re- 
lieved altogether. 

There is no question in the world but that the man 
would have died from hemorrhage had it not been con- 
trolled in the manner described; and the only other 
method whereby the hemorrhage could have been con- 
trolled would have been a serious operation that would 
most probably have cost the man his life. 

Case 38. Age 30 ; married ; chronic glandular prosta- 
titis, cystitis, abscess of prostate, metastasis, etc. At 
the age of 20 contracted gonorrhea, which lasted eight 
months, during which time the inflammation was ex- 
cessive. He was treated both locally and constitution- 
ally. This was followed by gleet, which was continuous 
for two years, when he had a second attack of acute 
gonorrhea. This latter lasted about eighteen months. 
The inflammatory condition was exceedingly severe, and 
was followed by gonorrheal rheumatism, cystitis, chronic 
inflammation of the prostatic urethra, prostatitis, and 
an abscess, rupturing into the prostatic urethra. The 
inflammatory condition extended from the meatus to the 
neck of the bladder. Besides various local applications 
to the urethra, and constitutional remedies, he was 



208 

operated upon at three different times, two of which left 
fistulous openings; one at one-half inch and second at 
an inch from the glans. Subsequently a perineal oper- 
ation was made for drainage, of eight weeks' duration, 
with a view of closing the fistula. This was a failure, 
and the openings remained patulous. Two years later, 
the old perineal incisions opened, and for a few weeks 
he suffered with an acute attack of prostatic urethritis, 
prostatitis, vesiculitis, cystitis. In fact, every pelvic 
organ of the patient was involved with profuse discharge 
through the perineal opening and the urethra. Fistulous 
openings existed through the urethra and bladder. This 
discharge resisted all local and constitutional treatments 
by the best physicians of Indianapolis and New York 
for three or four years, until he fell into my hands on 
the 26th day of February, 1905. A full account of this 
case, detailing the treatment for several years, will be 
given in the supplementary volume on Treatment. 
Normal conditions were finally obtained in the bladder, 
prostate and urethra. The symptoms were often aggra- 
vated by bouts of drinking. So complicated was this 
case both by lesion of adjacent organs, and so similar 
are other cases, that a detailed account of the treatments 
will be of unusual interest. 

Case 39. K. B., age 42 ; Tiffin, Ohio. He had suffered 
with local irritation for three years. Many physicians 
in his town had treated him for enlarged prostate, stone 
in bladder, and other troubles. He was about to be 
persuaded to have the gland removed, as he had been 
suffering intensely for the past month, having violent 
chills and rigors almost daily, followed with high fevers. 
Dr. L. A. Kellar directed him to come to me. I found 
a calculus three-quarters of an inch long, and one inch 
in circumference, in the prostatic urethra. After many 



209 

efforts this was dislodged, but it was too large to escape 
through the meatus, which was opened and it was 
removed. 

This man suffered from toxic uremia for two years 
previous to consulting me, also from vaso-motor dis- 
turbances superinduced by urethral and prostatic in- 
flammation, and glandular enlargement of the prostate. 
The bladder, too, was involved; although there were no 
stones found therein. The calculus referred to had be- 
gun forming within the prostatic gland, and the accre- 
tions to the calculus had continued until it had passed 
through the prostatic duct to the prostatic urethra, in 
which it became lodged. Recovery was prompt after 
the removal of the calculus ; and he returned home, after 
being under treatment three weeks. He was feeling 
well; and the last report from him is that he was per- 
fectly healthy and attending to his business daily. 

Case 40. J. H., age 75; strong, healthy man all his 
life. Began suffering three years before with prostatic 
trouble and inability to void urine. Catheter was used, 
which was followed by an acute attack. On the sub- 
sidence of this, he remained apparently comfortable for 
two years, then a recurrence more severe than the pre- 
vious attack ensued. The most prominent symptom was 
his difficulty in breathing, and (as he illustrated it) he 
seemed to choke up on each side of the neck just above 
the collar bone, along the course of the pneumogastric 
nerve. The first treatment after examination of the 
prostate completely relieved this difficulty of breathing 
and choking sensation, which at times had been so 
severe that it necessitated his grasping a beam, a tree, 
or a house to support himself until this blind choking-up 
sensation would pass off. The marked relief afforded 
this man by the first treatment of the prostate gland 



210 

cleared up the diagnosis at once. Although he had one 
or two mild attacks of difficulty of breathing afterwards, 
he never suffered any distress. Before he underwent 
treatment he had an extremely flushed and congested 
face. This, too, had subsided to a great extent. He had 
symptoms of sciatica, and had had one or two attacks 
of the same disease, which fact induced the writer to 
examine the rectum, when a "py-ro-sak" was located, 
but not relieved. Irritation of this ' ' py-ro-sak ' ' induced 
by the examination precipitated acute irritation of the 
sciatic nerve and left limb, making it very difficult for 
him to move about. He had been treated by his son, 
an osteopathic practitioner, several weeks before coming 
to me ; at first with negative results. This son came to 
visit him, and was evidently nettled at seeing the im- 
provement in his father, resulting from my treatment 
— when he himself had made no improvement. He, 
therefore, persuaded his father that the trouble with his 
limb was due to my treatment; and he carried him off, 
which, in my opinion, will cost the man his life, as I 
believe as firmly as I exist, that he could have been cured 
just as all the others had been by relief of the "py-ro- 
sak" that I had located. The osteopathic son never 
could locate or relieve it, and it will exist until it kills 
the patient. 



CHAPTER VI. 

Senile Hypertrophy and Its Complications with 
Cystitis, Vesiculitis, the Rectum, Etc. 

True hypertrophy of the prostate consists chiefly in 
indurated enlargement, as an outgrowth of the muscular 
fibers of the gland. The pressure exerted by this adven- 
titious growth upon the blood vessels and gland tissue 
perverts their function, nad ultimately induces paren- 
chymatous inflammation of the entire gland, and adjoin- 
ing structures. This form of disease is characteristic 
of middle or old age. It rarely occurs in men under 
forty-five, and more frequently after having passed 
sixty. Sir Henry Thompson places the time of life at 
which it most frequently occurs at from fifty-five up to 
seventy, but says that it rarely develops after seventy. 
Dr. Keyes places the time of its usual appearance after 
fifty. It must not be inferred, however, that in all men 
past forty-five, who suffer with prostatic disease, it is 
senile hypertrophy ; on the contrary, more men suffer 
from glandular enlargement, during that period of life, 
than from a hypertrophic induration of the gland. The 
proportion is about one hundred glandular to one of 
true hypertrophy. It is fortunate that such a proportion 
exists, as the glandular form is the more easily cured — 
in fact ninety-five per cent, of these latter cases are cur- 
able, and all can be materially benefited. The hyper- 
trophied condition is much more obstinate, and more 
difficult to relieve. The author until recently considered 
the large majority of these latter cases incurable, but 

211 



212 

recently improved instruments and remedies rendered 
them much more amenable to treatment. 

While this disease is characteristic of old age, yet 
exceptional cases occur at a much earlier period of life. 
It is quite common among physicians to ascribe all forms 
of diseases of the prostate to hypertrophy, and place 
the time of its occurrence anywhere from twenty-one up. 




Figure XX. 



213 

In fact many chronic urethral diseases that have proven 
rebellions to the ordinary methods of treatment have 
been pronounced hypertrophy, cancer or tuberculosis. 
It might be likened to Fothergill's interpretation of 
rheumatism, which, as he states, ' ' includes anything from 
the lightning pains of locomotor ataxia to the boring 
sensations of syphilitic ostitis." 

Figure XX gives a lateral view of the condition of 
true hypertrophy. By referring to this illustration, one 
will note P enlargement of third lobe. It shows, too, 
its encroachment upon the caliber of the urethra, closing 
it almost entirely. 

The more the urine accumulates, the stronger it 
presses this abnormal third lobe down like a valve, pre- 
venting the outflow of urine. It may be observed that 
by means of a catheter this can be pushed aside, and 
the catheter permitted to enter the bladder and evacuate 
the urine without trouble, yet immediately upon its 
withdrawal, the lobe P falls back in former position, 
obstructing the outflow. 

Clinical results of many cases of senile hypertrophy 
(see Figure XX) prove that the large majority of 
the cases suffering with this trouble have as the 
most prominent subjective symptom an obstructed flow 
of urine resulting from an abnormal enlargement of the 
third lobe. The opinion generally held by physicians is 
that senile hypertrophy is an enlargement of the . two 
normal lateral lobes of the gland. 

The writer has recently devised special means and 
methods by which he is enabled to remove the abnormal 
growth with impunity, oftentimes without necessitating 
the man stopping work. 

I wish to impress upon my readers that this condition 
of the gland, especially at first, is not attended with 



214 

the acute symptoms, such as a frequent desire to void 
urine, or the presence of pain. The chief subjective 
symptom is usually the obstructed flow, without the 
usual concomitant symptoms that attend the enlarged, 
congested glandular disease of this organ. 

The latter condition invariably results from ulceration 
of the prostatic urethra, while true hypertrophy super- 
venes upon glandular enlargement or some other cause. 

Clinical experience has demonstrated that the large 
majority of men troubled with prostatitis and enlarge- 
ment of the gland, even when past seventy-five, do not 
suffer from hypertrophy of the gland, but from gland- 
ular enlargement. I have treated and cured many men 
past eighty suffering from the latter, that had been 
treated for senile hypertrophy and pronounced incur- 
able. Such errors have not been confined to the general 
practitioner, but many had been treated by some of the 
leading genito-urinary specialists of the world. 

Causes. — The etiology of the disease has never been 
definitely determined. Several of the French writers 
have considered it analogous to the atheromatous condi- 
tion of the blood vessels, heart and other structures of 
the body, due to old age, resulting from undue accumu- 
lation of the earthy salts from the impaired functions of 
the eliminative organs. The various hypotheses as ad- 
vanced by different writers upon the subject are wholly 
speculative. It cannot be due to over use of the organs, 
congestion, or inflammation of the gland of long stand- 
ing, though the latter evidently tends in some instances 
to convert soft infiltration, as a result of such inflam- 
mation, into firm fibrinous structure ; yet I have known 
of numerous men who suffered more or less with prosta- 
titis for twenty-five or thirty years, that were free 
from fibrinous induration of the gland. Dr. Keyes 



215 

says: "The prostate is analogous to the uterus in the 
female, in regard to the nature of the muscular tissue, 
which composes it, and this analogy is further borne 
out by the tendency of both organs to develop fibrous 
tumors (so called) after middle life." 

The morbific changes that take place are not uniform, 
as in congested enlargement of the gland, but are usually 
nodular, or one lobe may be affected, independently of 
the other. The fibrinous band at the neck of the blad- 
der is almost invarably involved, sooner or later, forming 
a firm bar which serves to obstruct the flow of urine. 
This brings about various congested and inflammatory 
conditions of the bladder, the prostate and adjacent or- 
gans. Later this bar may develop to such an extent as 
to cause retention of a part or practically the whole of 
the urine, which undergoes decomposition, inducing 
thereby local irritation of the bladder, all the acute con- 
ditions and symptoms characteristic of glandular en- 
largement, and in addition calculi, or sepsis. Subse- 
quently, as the induration increases, it presses upon the 
vessels and gland structure until congestive inflammation 
and all attending symptoms demand immediate relief. 

The greater the accumulation of urine the more firmly 
is this bar "P" pressed against the opposite wall of the 
vesical neck, acting as a valve and preventing any out- 
flow of urine. The catheter can be inserted with ease 
and often with impunity into the bladder, pushing back 
this valve-like protuberance. At other times consider- 
able difficulty is experienced in passing this instrument 
properly, enabling it to turn upward and take the course 
of the changed canal. Special catheters are now made 
for this particular purpose — to make the curve prop- 
erly and to prevent the instrument from passing directly 
through the obstructed bar. 



216 




Figure XXI (Guterback) 



217 

Figure XXI illustrates the passing of a catheter 
through this bar — if the operator had had the proper 
instrument and knew how to use it, the condition seen 
in the illustration would have been prevented. Catheters 
made of silver or other metal, and sounds, are often 
forced through this bar. (b) illustrates the passage of 
the same catheter through the same obstructed bar, 
showing it entering the utricle in the prostatic urethra. 
The utricle often becomes distended, and admits the 
catheter, which is engaged more frequently at that point 
than at any other point in the urethra. 

False passages as illustrated by the above figure are 
extremely common, and the operator must specially avoid 
using force with any instrument when it reaches the 
deep urethra, as the prostatic urethra and adjacent parts 
become so soft and pliable from long standing conges- 
tion and inflammation that they easily break down and 
permit the passage of any instrument, even a small cath- 
eter, through their tissues. 

The abundant anastomosis of the veins of the prostate 
and bladder, with the hemorrhoidal, causes venous stasis 
in the rectal mucosa resulting in the formation of 
hemorrhoidal tumors, ulceration, or any organic lesion 
within the rectum. 

Symptoms. The symptoms must necessarily vary 
with the extent, condition and stage of the disease, and 
most of them are similar to those of congested glandular 
enlargement of the gland as heretofore described, with 
the exceptions pointed out. The enlarged gland often 
presses upon the rectum and interferes with the free 
evacuation of the bowels, causing constipation, and often 
flattening of the fecal matter, as it passes the obstruction. 
It is also somewhat difficult to start the flow of urine, 
at times, or to thoroughly evacuate the bladder. The 



218 

residual urine may dribble away, after cessation of the 
flow, onto the clothing, to the great annoyance of the 
man. The amount of the residual urine is in direct 
proportion to the size of the abnormal fibrinous band. 

Pressure upon the nerves of the prostatic, hypogastric 
and sacral plexuses provokes various reflex disturbances. 
Prominent among these are pains in the back, hips and 
limbs, disturbance of the stomach (which is a very 
common sequel of any form of prostatic disease). 

The bladder often becomes largely distended, from an 
over-accumulation of urine, impairing the detrusor 
urinae to the extent that they are unable to expel all 
the urine. This residuum increases as the disease pro- 
gresses, and becomes offensive from the decomposition 
of mucus and urea. Bacteria develop in large numbers, 
and the patient is in constant danger of septic poison. 
Sepsis is especially liable to a catheter habit, inasmuch 
as the microbic flora, always present about the meatus 
or fossa navicularis, are carried by the catheter into 
the bladder where conditions are so favorable for their 
development and engendering of septic poison, as clinical 
investigation has proven, that it has been impossible 
to maintain an antiseptic urethra. 

The catheter life of a patient has been estimated at 
an average of from four to five years. Sir Reginald 
Harrison gives this as the average time. There are ex- 
ceptional cases on record, where men have lived fifteen 
or twenty years using the catheter several times during 
the twenty-four hours. 

Diagnosis. The disease, for which hypertrophied 
prostate is most likely to be mistaken, is congested gland- 
ular enlargement of the gland, as before described ; and, 
it is not easy, in many instances, to differentiate between 
them, since each occurs during the same period of life, 



219 

and many of the subjective symptoms and complications 
are similar. 

In the early stage of hypertrophy the diagnosis may 
be more easily made. In this stage the gland is much 
less sensitive, unless it has been subjected to harsh 
treatment by sounds, caustic applications or other pro- 
cedures, when acute inflammation may have been the 
result thereof instead of the disease, per se. 

Even in glandular enlargement, which is often mis- 
taken for hypertrophy, the acute congested condition of 
this gland causes such tension upon the capsule sur- 
rounding the gland that it becomes so hard and tense 
that the condition is often mistaken for true indurated 
hypertrophy. 

By digital examination per rectum the gland, in true 
hypertrophy, is found to be unsymmetrical, and is some- 
what nodulated and irregular in outline. This latter 
condition also exists in tuberculous enlargement, yet 
this occurs so very rarely that it may not be considered 
as an important diagnostic point unless there exists con- 
stitutional indications of tuberculosis. 

Figure XXII. This illustration is of special interest, 
showing very marked enlargement of the middle lobe 
and hypertrophic growth of the lobe, causing atrophy 
of the verumontanum and a perverted condition of this 
important structure. It also shows an indurated, cor- 
rugated, condition of the bladder wall. There is also 
a small concretion attached to the upper portion of the 
middle lobe. 

In hypertrophic conditions of the gland the two lobes 
are not symmetrical; one lobe may be nodulated from 
the pressure of tumors, and the other not be affected. 
Both lobes of the gland are rarely of the same size 
and consistency, and there is little or no tenderness upon 



220 




Figure XXII (After Cruveilhier). 

pressure, unless inflammation has extended to the gland 
from complications of the bladder or rectum, or the 
extreme size of the organ has obstructed the flow of urine 
and caused a congested inflammatory state of its gland- 
ular structure and bladder. When such condition exists, 
there is often a profuse discharge both from the gland 
and vesicles. 

In enlargement from glandular congestion the lobes of 
the prostate are uniform in size, less firm, unless it is 



221 

very much swollen and the capsule is subjected to ex- 
treme tension. It is also tender upon pressure ; the ten- 
derness extending to the glans penis or perineum. 

The hypertrophied, indurated and contracted bladder 
often becomes sacculated as a result of some of the 
detrusor urinae becoming partially paralyzed from over- 
distension. The urine often deposits or precipitates 
within these sacs, and remains without being expelled 
for a long while. In such conditions there often develops 
calcareous matter, at times forming the nucleus or even 
causing the development of stones of such size as to be 
easily detected by the cystoscope, when they are not 
covered with folds of the muscular Avails of the 
bladder. In the majority of instances, where calculi 
have become imbedded within these sacs, distension by 
air of the walls of the bladder reveals them through 
the cystoscope. 

Another valuable diagnostic point is that the prostatic 
urethra is invariably elongated, when a third lobe has 
developed. This elongation can be easily detected by 
means of a thin, flexible bougie. Pass the bougie through 
the urethra, noting carefully the resistance as it passes 
through the prostatic urethra and through the elongated 
part (induced by the abnormal third lobe). Note the 
distance the instrument has passed over before it enters 
the bladder (which is indicated by the absence of resist- 
ance when it leaves the third lobe ) . 

Carefully withdraw the instrument (first noticing or 
marking a point on the bougie close to the meatus), 
and measure from this point to the terminal extremity 
of the instrument. 

By this means the distance from the triangular liga- 
ment to the entrance into the bladder may be ascer- 
tained. Normally this should be one and one-quarter 



222 

to one and one-half inches ; when hypertrophy is present 
the distance is two and one-half to three inches. 

In order to accurately determine the length of the 
canal as induced by this indurated enlargement (third 
lobe) one should stretch the penis to its full extent, 
then compare the length of the urethra thus ascertained 
with that of the normal urethra as determined by the 
individual case. Some men naturally have an urethra 
nine inches long — but this point must be determined by 
the length of the urethra from the meatus to the pros- 
tate or (more properly) to the triangular ligament. 

This is one of the easiest diagnostic points by which 
to differentiate between glandular enlargement of 
the prostate and true indurated hypertrophy. I 
dwell on this to some extent as it is very important 
for one to know whether the case is curable by means 
of the remedies and instructions devised for glandular 
enlargement. 

"The differential diagnoses with reference to these 
two diseases of the gland are very important, inasmuch 
as one condition is curable and the other is not, and 
the curable one is so often mistaken for the other, and 
the patient subjected to dangerous and useless opera- 
tions, that are irreparable." The foregoing statement 
was made ten years ago in the first edition of my book. 
Since that time the author has been enabled to cure 
the majority of those diseases that were at that time 
considered practically incurable. New instruments and 
remedies have been devised, by means of which this third 
indurated enlarged lobe can be removed, and the fibrin- 
ous element of development arrested; so that thereafter 
the man passes urine practically normal, and with as 
little or even less trouble than most men of his age who 
do not suffer from such trouble. 



223 

My present methods are fully explained and illus- 
trated in the supplementary volume to this work. The 
medicinal agent and the instruments are fully described, 
and their applications in the different stages of various 
lesions and diseases thoroughly elucidated. Any intelli- 
gent physician should by following the directions given 
be able to cure the diseases dealt with, instead of in- 
flicting upon his patient dangerous and senseless oper- 
ations, as, for instance removal of the gland. 

Treatment. Hypertrophic prostatic diseases, owing 
to their intractability and the involvement of adjacent 
organs, have been made by ambitious surgeons the ob- 
ject of many operative procedures, each of which chal- 
lenged his predecessor in the endless suffering entailed 
upon its victims, or in lethal dangers, and supplying a 
topic for lengthy discourses and discussions in medical 
societies upon the superior claim of each operation. I 
may refer to the instance mentioned in a succeeding 
page, of a country doctor who reported that he had 
performed twenty-six such cases "without failure." 
Notwithstanding this claim, during the discussion which 
followed he acknowledged, "as to the results ... I 
expect the next set will all die." 

The treatment which was generally advised in such 
cases in the past was the removal of the gland together 
with the adjacent structures. As a matter of fact, the 
removal of the gland alone without the removal of the 
adventitious arbnormal structures, would not serve the 
desired purpose, as these latter would obstruct the flow 
of urine. In view of this fact, by simply noting the 
illustrations of the indurated, thickened condition of the 
walls of the bladder, and the abnormal condition of other 
structures, one can see at a glance that all the structures 
are prerequisite to a thorough evacuation of the bladder. 



224 

Removal of the parts involved would necessarily prove 
fatal. 

Before proceeding to describe my method of treatment 
in cases of senile hypertrophy, I shall briefly refer to 
some aspects of the surgical operations by which a rad- 
ical cure of the disease is attempted. 

The prevalence of the disease has offered a tempting 
field for the exploitation of surgical ingenuity and the 
innumerable methods proposed, those of Tobin, Mercier, 
Bottini, Harrison, Dittell, McGill, Belfield, Treves, 
Whitehead, Dolbean and others, have one and all found 
enthusiastic followers and formed the subject of much 
medical literature. 

Surgical operations for the relief of urinary troubles 
resulting from enlargement of the prostate fall into two 
classes. The first consists of the various methods by 
which the gland is attacked directly ; the second embraces 
the procedures that aim at reduction of the blood supply 
of the swollen organ and consequently atrophy thereof. 

Direct interference of the diseased organ is effected 
through the urethra (as in the Bottini operation), or by 
the perineal route (lateral prostatectomy), or by means 
of suprapubic incision. By the last method, the gland, 
especially the middle lobe, is removed bit by bit with the 
rongeur forceps, or a wedge is cut out with scissors, or 
the organ is destroyed by Paquelin's cautery or the gal- 
vano-cautery. Prostatectomy by combination of supra- 
pubic and perineal methods has also its followers. 

The operations undertaken for the purpose of reducing 
the blood supply of the gland and so bringing about an 
atrophied condition are either direct or indirect in char- 
acter. The direct method consists in ligating the arteries 
which feed the prostate, i. e., simultaneous ligation of 
both internal iliac arteries. 



225 

The indirect method is orchidectomy. The theory on 
which this latter procedure is based is, that the hyper- 
emic condition of the genital system is diminished by the 
removal of the nervous reflexes which are induced by 
the congested inflammation of the prostate, which was 
superinduced by normal secretions of the testicles. The 
removal of the testicles was supposed to overcome the 
nervous reflexes induced through the prostatic ganglion 
and genito-spinal center. In turn this overcame the 
normal congestion of the gland that takes place during 
erotic excitement. The theory, however, proved disas- 
trous in many respects; giving rise to serious troubles, 
such as insanity, suicides, etc. 

This multiplicity of surgical methods of dealing with 
the hypertrophied prostate has its parallel in the variety 
of theories that have been propounded as to the cause of 
the disease, as for instance, that of Guyon, who regards 
it as simply a part of the constitutional condition pe- 
culiar to old age, and characterized by arterial sclerosis; 
or that of Harrison, who regards the growth as com- 
pensatory in character and secondary to certain bladder 
changes. Others believe that prolonged, ungratified sex- 
ual excitement causes enlargement of the prostate. But 
here we are met with the difficulty of distinguishing 
cause from effect, for there is plenty of evidence to show 
that the enlarged prostate is a cause of abnormal sexual 
excitability, in some cases, while in the majority it has 
the opposite effect of causing impairment or total im- 
potency. In point of fact, the probable cause of many 
of these troubles (as evidenced by the age at which 
they usually appear) is similar to that which produces 
changes in women at the menopause, including the 
growth of fibrous tumors in the uterus. This change in 
men evidently brings about that tendency to change of 



226 

normal nervous condition, which precipitates fibrous 
developments in the prostate similar to those produced in 
the uterus of a woman. 

In conclusion I will state that the various operations 
which have been commended and followed for vary- 
ing periods have, like the Bottini, been attended with 
such serious, even fatal, results as to be one after an- 
other abandoned. Further reference to these matters 
will be made in the supplementary volume. 

On account of the celebrity of Bottini 's operation and 
to show the dangers which lurk in it, I will here say a 
word or two regarding it. Enrico Bottini 's galvano- 
cautery radical operation for hypertrophy of the prostate 
was first performed in 1875. The instrument as used was 
catheter-shaped, of medium caliber, with short beak 
carrying a platinum plate (three-quarters inch in 
length) on a porcelain disc. The plate, rendered red-hot 
by electric current, was used to cauterize the prostate. 
In a short time this cauterizer was discarded for a pros- 
tatic incisor, the instrument consisting of a male and 
female arm. A platinum knife (five-eighths inch long) 
in the male arm leaves the female arm on working an 
outside screw, and a cooling mechanism prevents burning 
of the parts by any other portion of the instrument than 
the knife. The incisor was intended to remove the me- 
chanical obstruction to the outflow of the urine by slowly 
burning a groove or grooves through the enlarged pros- 
tate. The operation, however, simply effected a splitting 
of the gland, which in a short time healed, and the parts 
again grew together. The condition after the operation 
was practically the same as before; besides, the patient 
was subjected to a dangerous operation, and the inac- 
cessibility of the parts caused great difficulty in controll- 
ing the resulting hemorrhage by ordinary means. Even 



227 

after its improvement by Freudenberg the operation 
soon became obsolete. 

Regarding the other surgical methods above referred 
to but little need be said here. Prostatectomy, whether 
by the suprapubic or perineal route, or by combination 
of these methods, is always accompanied by the danger 
of sepsis, hypostasis, and above all of uremia. This opera- 
tion has become quite popular of late years. 

I fully concur in the opinion expressed by Dr. Orville 
Horwitz, as published in the Medical Times of August, 
1901. In summarizing the results of one hundred and 
sixty-one operations for the relief of senile hypertophy 
of the prostate, he says : "With the exception of ligation 
of the internal iliac arteries, prostatectomy is the most 
dangerous of any operation that has been recommended 
for the relief of prostatic obstruction, due to hyper- 
trophy." Yet there are some newly-fledged surgeons 
who harp upon the operation being practically free from 
danger. 

About thirty years ago prostatectomy was unquestion- 
ably a fad. Subsequent results led conservative surgeons 
to weigh well its many dangers as compared with the 
small number that were at all benefited. The unsatis- 
factory results obtained caused most of the prominent 
practitioners in the United States to abandon the opera- 
tion as unsafe. 

Professor E. L. Keyes, whom I regard as the most 
prominent genito-urinary specialist and author in the 
United States, if not in the world, had advocated its use, 
but now is amongst those who denounce the operation 
as pernicious. "A wise man changes his opinion; a fool, 
never. ' ? 

In the last edition of Professor Keyes ' book on Genito- 
urinary Diseases, page 288, he says: 



228 

"Twenty years ago no one operated upon the hyper- 
trophied prostate. Today every surgeon approaches 
this organ with a knife or a cautery in his mind if 
not in hand. The mass of literature on this subject is 
appalling. Everyone operates; everyone writes; every- 
one defends his own views in his own way; the result 
is that the variety of operations almost equals the num- 
ber of operators. . . . On one point only do they all 
agree implicitly, if not explicitly, viz., the prostate 
may not be operated upon with impunity." In one 
of the latest works on surgery of the prostate, by John 
B. Deaver, page 12, after describing the operation (as 
claimed) of enucleation and removal of the prostate, the 
author says: "Many other surgeons have labored to 
prove that such an operation is not only surgically, but 
even anatomically impossible, assailing Mr. Freyer's 
claim of originality." 

He continues : "It seems a pity that so many contro- 
versies in regard to surgical priority are so constantly 
arising, and it appears that prostatic surgery is par- 
ticularly unfortunate in this respect. Riolanus bitterly 
denounces his contemporaries for claiming as their own, 
operations which had been employed before their grand- 
fathers were born"; and abandoned. 

During the last few years I have followed up every 
case upon whom prostatectomy had been performed, 
which has come under my personal observation, to note 
the immediate and ultimate result of this operation. 

Case 1. Lived in Sioux City and was operated upon 
in Minnesota. He was reported by his friends as cured ; 
three weeks thereafter they reported he was well. Six 
weeks after the operation he applied to the writer for 
relief of pain from which he suffered every five to fifteen 
minutes. His urine, which was of dark, muco-purulent 



229 

character was of the most offensive odor, and passed in- 
voluntarily into a urinal which extended down his leg 
to his ankle. Three months afterwards he had a stroke 
of paraplegia, and was rolled about in a chair, as he 
could not stand up on his feet. Nine months later he 
died very suddenly owing, it was said, to a " brain clot. ' ' 

Case 2. Operated on in Chicago, died three days 
after the operation, from hemorrhage. 

Case 3. Operated on in Minnesota. Was reported 
well at the expiration of the fourth week. He had to 
wear a urinal. Three months thereafter he reported 
that he had but little trouble. Six months afterwards 
he began having serious trouble in voiding urine, and 
stated that the urine was very dark in color, and offen- 
sive most of the time. Thirteen months afterwards he 
died from abscesses in the perineum, and sepsis. 

Case 4 was reported to the writer by Dr. Murphy of 
Paducah, Ky., who stated that the man suffered hor- 
ribly, from the day he was operated upon until he 
finally died from sepsis and abscesses in the perineum 
and adjacent structures. 

Case 5. Operated on in St. Luke's Hospital, Chicago. 
He was a man of robust health, whose urine suddenly 
became obstructed during an acute attack of chronic 
enlarged prostatitis. Numerous efforts to evacuate the 
bladder failed. Twelve hours later he was carried to a 
hospital and prostatectomy was attempted. For about 
two hours a so-called prominent surgeon (on hospital 
staff) cut, gouged and punched, trying to enucleate the 
prostate (sic). Finding the opening too small at first, 
it was enlarged. The opening still not being sufficiently 
patulous, it was again enlarged. After several attempts 
and failure to extricate the gland through this route, the 
surgeon abandoned this course, and tried the perineal 



230 

route. Becoming disgusted with the surgical (sic) pro- 
cedure, Dr. Smith and I left the operating room. Dr. 
Chamberlin and Dr. Shannon, who were also present, re- 
mained to the end. I saw one of them the next day and 
asked what was the result. The reply was that the man 
died on the operating table after about two hours ' at- 
tempt at removal of the gland, but he never did get it out. 

Case 6 was that of a man forty-five years old, where 
the gland had been removed three months. During 
this time he suffered intensely, and there was continual 
dribbling, which necessitated his wearing a urinal. On 
introducing the catheter, there was no urine following its 
entrance into the bladder; but upon its withdrawal to 
eight inches, from one to two drams passed. He said 
that he thought he had suffered before the operation, 
but that it was nothing compared with the pain since. 
He left and nothing more has been heard of him. 

(A), Figure XXIII, shows diagramatically the vacant 
space where the prostate gland has been removed. As 
the urethra passes from the bladder through the upper 
third of the gland (as the dotted lines indicate), and is 
connected directly with the two lobes of the gland by 
eight or ten prostatic and two ejaculatory ducts, it is 
evident to anyone familiar with the anatomy of the 
prostate, that it is surgically and anatomically impossible 
to remove this gland without removing also the urethra 
and the two sphincter uringe muscles, whose province it 
is to retain the urine in the bladder. Their removal 
allows the urine, as fast as it is secreted and percolates 
through the ureters into the bladder, to pass on into this 
sinus (A). There is no obstruction to the passage of 
semen also into this same sinus. Here the urine and semen 
decompose and become septic ; and under such conditions 
the formation of abscesses in the perineum is favored. 



231 




Figure XXIII. 



Such being the case, one can appreciate the query of 
Dr. Johnson, of Arrowsmith, 111., who wrote: "Dear 
Doctor: A Mr. K. of this place was operated upon for 
prostatectomy in the spring of 1909. I had to catheterize 
him yesterday, but failed to get any urine ; yet, when 
the catheter was withdrawn, the urine began dribbling. 
Several other doctors have catheterized him, and no one 
has ever got urine from the bladder. Profuse hemor- 
rhage followed one of these attempts. Please explain 
why there is no urine in the bladder. ' ' 



232 

The explanation is patent to anyone who has read the 
description of the operation — the sphincter muscles hav- 
ing been removed, there was no means of retaining the 
urine within the bladder. 

Figure XXIII, (C) points to the inflamed portion of 
the bladder resulting from a chronic enlarged prostate. 
( E ) is the border line between the sinus and the bladder ; 
when it is necessary to use a catheter it is very difficult 
to find the urethral opening to the bladder. 

In the case mentioned above, a stricture formed at (B) . 
which made it difficult to evacuate even the sinus. This 
subject has lived longer in the condition described than 
any other that has come under the notice of the writer. 

Enucleation of the prostate gland "is an impossible 
operation" — see page 13 of Deaver's late book on "En- 
largement of the Prostate." 

Figure XXIV illustrates diagramatically the prostate 
and the ejaculatory duct as it enters the urethra (b), 
passing through the prostate gland (p.p.p), the two 
lobes of the prostate being tunneled by the ejaculatory 
duct and urethra. The prostatic ducts are not shown in 
this illustration. The main points of interest in this cut 
are the two sphincter-urinae muscles, the internal and 
external (a, c) respectively. The points to be remem- 
bered in these illustrations are that in the removal of the 
prostate (as claimed) by enucleation, the operator must 
necessarily remove at the same time the two sphincter- 
urinae muscles, thereby removing the only means by 
which urine is retained within the bladder, or prevented 
from constantly escaping by dribbling through the sinus 
formed by the operation. 

There are so many of these so-called "surgeons" (?) 
that report results and publish them in some medical 
journal after having read them to a medical society that 



233 




Figure XXIV. 



are utterly misleading to the ordinary practitioner either 
that reads these reports in the journal or hear of them 
in the society. One of these was published in the Jour- 
nal of the Kansas City Medical Society of July, 1908, 



234 

in which one of the surgeons (sic) reported twenty- 
six cases upon whom he had operated npon without a 
failure. An old, honest, long-tried physician, Dr. Jones, 
arose slowly and said, "I was not going to say a word 
about this. There are one or two points that have not 
been brought out. It has been my observation that these 
cases in the hands of most operators, men of unques- 
tioned ability in the line of operative procedure, that 
they lose a very large majority of their cases. I recall 
a series of three operations in one day by a man whose 
reputation is a by-word in the American profession and 
all three of these cases died within thirty-six hours. ' ' 

ANOTHER EXAMPLE OF WHAT WE READ IN THE NEWSPAPERS. 

J. W. H. writes: "My urine now is continuous. 
I wear a rubber urinal. My leg swelled. Took a 
hot sulphur bath, which reduced the swelling. Can 
the urine be checked?" 

Reply. — You have an enlarged prostate. As a 
consequence, your bladder has become infected. The 
swelling in your leg indicates that the infection has 
traveled to your kidneys. A urine analysis will 
show the state of your kidneys. This analysis and 
a physical examination will show the condition of 
your bladder. 

If your kidneys and bladder are now in condition 
to warrant or your doctor can get them in condi- 
tion, the thing to do is to have the prostate removed. 
See a physician and go to work along these lines. 

You should not have neglected this condition so 

long. You should have had your prostate removed 

before these other organs became involved, at least 

so badly involved." ~ m 

Chicago Tribune. 



235 

The foregoing has been copied that I might make 
comment, inasmuch as this emanates from one of the 
most noted physicians in the State of Illinois. We have 
here published advice to a layman from a so-called 
" ethical physician" to have his prostate removed, with- 
out the physician even knowing the condition of the 
man, the condition of his prostate, whether senile hyper- 
trophy, glandular enlargement, or in fact, whether there 
is any serious disease of the prostate. The man narrates 
symptoms which are common to cystitis, prostatitis, 
or urethritis, and which may exist without any disease 
of the prostate itself, yet he recommends removal of 
the prostate, and condemns the man for not having had 
it removed before. 

Now, if a man of such repute gives such advice, prac- 
tically consigning the man to a premature grave, what 
would be expected of the ordinary general practitioner? 
Is it a wonder that medicine and surgery have not prog- 
ressed with all this science instead of retrograding ? 

Case 41. A lawyer ; aged sixty-eight ; married ; nega- 
tive history. He had observed some slight difficulty in 
voiding urine for about five years. There was no pain 
attending the act, at first, but it required longer time 
than normal, and some effort to thoroughly evacuate the 
bladder. This condition gradually became more pro- 
nounced, until he observed that he could not entirely 
empty the bladder. He then consulted his family phy- 
sician, who began the use of sounds, then the catheter. 
The urine became turbid, ammoniacal and very offen- 
sive after standing. "Washing of the bladder was re- 
sorted to, without any relief. 

When he consulted me he had to use the catheter 
from four to five times during the twenty-four hours. 
He was able to expel by force, at times, from one to 



236 

four drachms. It contained a large quantity of mucus 
and pus, strongly ammoniacal in odor, and alkaline in 
reaction. 

Both lobes were hypertrophied — the left one more 
markedly. The bar at the neck of the bladder was espe- 
cially large, and firm. There was no tenderness upon 
pressure of the gland through the rectum. Its large 
size obstructed the fecal discharge, causing constipation. 
There was very slight tenderness in the prostatic urethra, 
notwithstanding the long continued use of the catheter. 

The urethra, as determined by means of a bulbous 
bougie, measured ten and one-half inches; through the 
prostatic urethra to the entrance of the bladder two and 
one-half inches. It was quite noticeable when the in- 
instrument had passed through the constricted orifice 
made by the encroachment of the third lobe upon the 
neck of the bladder. After the instrument had ceased to 
encounter resistance in its passage then I knew that it 
had entered the bladder and could measure from that 
point, and so determine how much the urethra was 
elongated compared with the normal length. 

Another method of determining the elongation of the 
urethra is by measuring the distance between the en- 
trance into the bladder and the beginning of the pros- 
tatic urethra, that is, the triangular ligament. 

The method is to insert the bougie until it enters the 
bladder ; then to slowly withdraw it, observing the point 
where the first resistance to the passage of the bulb is 
met with in the constricted orifice. The next point is 
to note where the bulb of the instrument passed through 
the prostatic urethra and entered the membranous ure- 
thra, as indicated by a jumping or sudden passing over 
the triangular ligament — then to measure the distance 
between these two points. 



237 

The use of the catheter was continued, as required, 
to evacuate the bladder. At the end of the first month's 
treatment, it was necessary to use the catheter on an 
average of every second day. At times he would not 
use it oftener than the third or fourth day, then again 
daily for a few times. 

This condition continued, with some interruptions, for 
four months. He would occasionally go two weeks with- 
out using the catheter, then again had to use it daily 
for a few days. His. general health was much improved, 
having gained fifteen pounds in weight. The treatment 
was discontinued for a month, and again resumed ; and 
continued two months longer, when he returned home. 

On his first return home he was very much discour- 
aged; but within a short time he wrote to the author 
that he was much improved and almost well. He stated 
that his improvement began after he had been home 
about four months, and that it was steady and well 
sustained. He continued to grow in weight and strength. 
His digestion had become good, and his bowels were 
working in a natural way, as he expressed it. The 
heavy thick sediment in his urine and the pain in the 
bladder had both disappeared. 

Four years thereafter he called at my office, and his 
condition was that of a strong, healthy, robust man. 
He stated that he had been in perfect health since he 
last wrote to me, which was about four months after he 
had returned home. He feels now as if he had never 
had a sick day. 

Case 42. Hypertrophy of prostate, cystitis, proctitis. 
Physician, aged sixty-nine ; married ; had gonorrhea in 
early manhood, from which as he supposed he readily 
recovered. He had ridden horseback a great deal up 
to his sixty-fifth year, without discomfort. About that 



238 

time lie began to feel an uneasiness in the region of the 
perineum. The flow of urine had also become sluggish, 
and somewhat difficult to start. He abandoned the 
saddle for a buggy, when he soon found it necessary 
to use a pneumatic rubber ring for a seat, and to empty 
the bladder with catheter. The catheter had been in use 
for more than a year when I first saw him. His general 
health was very much impaired. 

Upon examination I found the left lobe very much 
enlarged, the right less so, but quite nodular. There 
was very slight pain upon pressure of the gland. The 
adjacent tissues were somewhat congested and tender, 
from obstructed venous circulation. The muscular bar 
at the neck of the bladder was very large and firm. 

His condition was somewhat encouraging, and then 
would become somewhat like it had been formerly. As 
I did not know at that time as much about controlling 
and curing these conditions of true hypertrophy as I do 
now, he drifted along for several years, with varying 
results. At times he had but little residual urine, at 
other times he wasi unable to evacuate the bladder with- 
out a catheter. Some years thereafter I insisted upon 
his return, stating that I had so improved my methods 
as to be now able to promise him better results than 
formerly. 

The results of treatment at this time were very tedious 
and very unsatisfactory. At the expiration of three 
monthsi the congested inflammatory conditions had been 
very greatly allayed, and he suffered but very little 
from acute symptoms. But the obstruction to the flow 
remained practically the same. The only advantage that 
resulted from treatment at that time, was that by allay- 
ing the acute symptoms the catheter could be introduced 
with less discomfort, and its use was not called for so 



239 

frequently. He was sent home in this condition, and 
remained practically comfortable for several years. He 
came back at that time for treatment, and is now prac- 
tically cured of his trouble. This case will be further 
dealt with in following pages. 

Case 43. J. B H. Farmer; negative history; five 
children; had been strong and healthy until sixty years 
of age. He then began suffering with what he termed 
"kidney trouble," with excessive pain in the back, void- 
ing urine frequently, though only a little at a time; 
marked pain in the right hypochondriac region when the 
bladder became filled. He described it as a painful lump 
in his sdde. He had never been enabled to thoroughly 
evacuate the bladder; he had not used a catheter. By 
means of the latter, 12 ounces of offensive urine was 
evacuated, which gave relief to the painful lump. There 
was but little acute inflammation about the prostate, but 
it was true hypertrophy. Relief of this enabled him to 
evacuate all but an ounce of urine — at times there was a 
residue of only one-half ounce. He was completely re- 
lieved of the pain in his side, although the backache 
remained. After the third week of treatment, he began 
passing large quantities of grayish-white flocculent mat- 
ter from the pelvis of the kidney on alternate nights. 
By the way, this matter that passes from the pelvis of 
the kidney usually passed at night, and is evacuated 
early in the morning. He stated that he had passed 
fully a quart of this "whitish burning stuff." He in- 
sisted upon knowing where it came from, as he said he 
had never passed it before. At the expiration of a week, 
the urine completely cleared up and assumed its normal 
straw-colored, trnslucent appearance. 

He returned home greatly improved in health and 
strength, but after remaining six months, he complained 



240 

again of this lump in his side and of his backache, and 
I insisted upon his returning for further treatment. 
He again passed a considerable quantity of whitish-gray- 
ish matter from the pelvis of the kidney, but not so much 
as at the former time. At the expiration of two weeks 
this subsided, the pain in his back disappeared, and he 
returned home apparently well, and has not been heard 
from since. 

It is a most pernicious habit that some physicians have 
of attempting to catheterize the ureters and the pelvis 
of the kidney. No good can be accomplished thereby, 
and infectious matter is very liable to be carried from 
the bladder to the kidney and give rise to acute pyelitis. 
I never saw but one case where the pelvis of the kidney 
had completely filled with calculi, forming projections 
even into the calices. It is exceedingly rare also for 
the true parenchyma of the kidney to become affected 
as a result of this, unless it is provoked by catheteriza- 
tion, as acute inflammation of the bladder is provoked by 
improper treatment. 

The large majority of cases that apply for treatment, 
including those as young as 30, suffer with pyelitis and 
have this whitish flow from the pelvis, and it is almost 
invariably termed " Bright 's disease," or disease of the 
kidney. While the pelvis is part of the kidney, yet by 
reason of its anatomic construction and direct continuity 
of tissue, it is more associated with the bladder and 
ureter, than with the parenchymatous structure of the 
kidney. 

Clinical observations, especially during the last few 
years, has convinced the author that the large majority 
of cases of so-called " Bright 's Disease" are no more 
nor less than pyelitis, or inflammation of the ureter 
incident on pyelitis, this involving the pelvis and caus- 



241 

ing swelling of the lining of the tunic of the ureter so 
as to obstruct the passage of the whitish chalky thick- 
ened urine from the pelvis to the bladder and thereby 
causing severe pressure within the pelvis, pyelitis and 
acute interstitial nephritis. More men die from this 
source of trouble of the kidney than from all other 
forms of kidney trouble combined. 

Case 44. On May 3, 1911, an old soldier w r as sent by 
Dr. Hoy, of Syracuse, Indiana. Aged sixty-nine, mar- 
ried, four children. Began having difficulty in voiding 
urine, three years prior thereto. The urine passed only 
by dribbling. The walls of the bladder had yielded to 
the over-accumulation and pressure of urine, until a sac 
formed, which bulged upon the left side, forming a large 
pouch, or "lump," ast he called it. Attempts at cathe- 
terization had failed by his physician, who sent the man 
to the writer. After many efforts to evacuate the blad- 
der I finally succeeded in drawing off 42 ounces of 
offensive, thick, purulent urine, not all at once but 
within two hours. Great relief followed. Thirty-eight 
ounces were taken on the following day. He was treated 
at my office, daily, for one month, when he was sent home 
in fairly good condition, the lump having disappeared, 
with only a few ounces of residual urine during twenty- 
four hours. After remaining home two weeks, he re- 
turned and had another month's treatment. He had 
gained fifteen pounds in weight, in good health, and 
doing light work. On October 20, 1911, he "called to 
let you see I ain't dead yet. I am feeling fine. I just 
came from the hospital, where one of my old comrades 
was operated upon day before yesterday. He is doing 
fine, and says that the doctor told him he would be all 
right in two weeks. Two men are waiting to be operated 
upon this week." 



242 

October 28th: "I came from the hospital. All three 
of those fellows that were operated upon are doing fine. 
They were after me to let them cure me. I said : ' ' Well, 
I '11 wait and see how you are all going to turn out. ' ' 

November 10th. : "I have just come from the hos- 
pital. All three of those fellows operated upon are 
dead. I don't want any of that kind of cure in mine." 

Thisi man had been an old soldier, and was suffering 
some from the effects of his army experience. I have 
kept in touch with this man, and he has been in fairly 
good condition ever since he was treated, and is still 
doing farm work. 

Case 45. M. L., age seventy-six, married; applied for 
treatment on Feb. 19, 1910. Physical examination re- 
vealed exceedingly tender urethra, especially in pros- 
tatic portion. He was compelled to pass a catheter 
from six to eight times a day and from four to five times 
at night. He could not pass a drop without the cathe- 
ter, and its constant use maintained an acute sensation, 
that was quite difficult to relieve, when necessitated to 
evacuate the bladder. 

The gland was very large, measuring four by 
two and one-half inches. At times, profuse hemor- 
rhage followed the withdrawal of the urine, which 
was ladened with pus and mucus. Epithelia evi- 
denced the fact that the pus came from the pel- 
vis of the kidney. He also suffered with metastatic 
rheumatism, lumbago, sciatica and paresis of the left 
side. He stated that he had been advised by two phy- 
sicians that nothing could be done for him except to 
cut out the prostate gland. He had a friend, upon 
whom the operation had been performed, that died, so 
he declined to have the gland removed under any cir- 
cumstances. This man was extremely prostrated and 



243 

anemic; his general appearance showed the toxic effect 
of the absorption of muco-purulent matter, as well as of 
disintegrated urine. In external appearance this case 
was one of the worst the writer had seen for a long 
time. The odor evidenced that much of the toxic matter 
was being eliminated through the skin. The bowels were 
costive and very difficult to evacuate without depressing 
him too much. 

He began improving from the beginning of the treat- 
ment, and in two weeks' time, he was voiding some 
urine naturally. At the end of three weeks, there was 
only three ounces of residual urine and he was using 
the catheter only once daily. At the expiration of six 
weeks he was perfectly well. He left for home, and I 
did not hear any more from him until I received the 
following letter from one of the physicians who had 
advised him to have the prostate removed : 

"Willow City, N. D., June 7th, 1910. 

"Dr. Geo. W. Overall, 
"Chicago, 111. 

"Dear Doctor: 

"A patient of mine, a Mr. M., has recently returned 
from Chicago where he was under your care for about 
six weeks. Before he passed out of my care I had ad- 
vised operation for the prostatic hypertrophy, from 
which he suffered, but he tells me that you have com- 
pletely relieved him from all symptoms by means of your 
treatment. He is very loud and emphatic in his. praises 
of you, your methods and is indeed a very grateful 
patient. 

Would it be asking too much if I ask for particulars 
of your treatment. "Cordially yours, 

"D. K. Thyng, M. D." 



244 

Owing to the extreme prostration of the man when he 
first visited me (he had served in the Civil War, and 
the consequent exposure probably had something to do 
with his prostration) I was much gratified at the cure 
of this man, and have kept in touch with him up to the 
present day. I think being a farmer and living a simple 
life enabled him to rally better than otherwise would 
have been the case. 

This case was one of true, indurated hypertrophy, as 
illustrated by Figure XX. The result in this case was 
most remarkable, for three reasons : first, on account of 
that of his age ; secondly, on account of the involvment 
of the entire bladder and adjacent organs; thirdly, the 
pyogenic condition of the pelvis of the kidney. 

Reports recently show that this man is still in normal 
condition, regardless of his advanced age. 

Many similar and well authenticated cases will be 
reported in the book. 



CHAPTER VII. 

SIGMOIDITIS, PYRO-SACS, AND THEIR COMPLICATIONS. 

While there have been numerous volumes written 
upon the subject of diseases of the rectum, and while 
there are a great many physicians who make a special 
practice of rectal diseases., there is not one known to the 
writer who is familiar with its chief characteristic 
lesions. 

More recent observations have convinced the writer 
that of the long standing chronic diseases of any nature 
from which people suffer fully one-fourth are compli- 
cated with diseases of the sigmoid-nexure. It is a fertile 
source of trouble, giving rise directly or indirectly to 
appendicitis — and relief of this lesion prevents or re- 
moves the etiological factor of the appendicitis. I am 
not stating this asi a theory, but base my assertion upon 
practical experience of cases of patients ranging in age 
from 22 to 86 years. 

Figure XXV gives a diagrammatic illustration of a 
typical case of phagedenic ulceration, degeneration, and 
stricture of the sigmoid-nexure. The ulcerated tissue in 
this case was of such nature that on being touched with 
a fledget of cotton wool it would bleed freely, and the 
tisisue itself was so friable that it would easily break 
down under this soft cotton application. 

Although it partook of a carcinomatous nature and 
was attended with an offensive discharge, it yielded read- 
ily to treatment. Notwithstanding the severe character 
of this ulceration, there was no pain or irritation to call 

245 



246 




Figure XXV. 



attention directly to it. The most prominent objective 
symptoms observable were extreme constipation, indi- 
gestion, neurasthenia, insomnia, and various nervous 
disturbances. There was no pain in the left hypochon- 
driacal region, as might be inferred from the presence 
of such an extensive ulceration as appears in the illus- 
tration. The lumen of the bowel had become so occluded 
at the juncture ST with granulated masses of proud 
flesh and constriction that it would not permit an instru- 



247 

ment the diameter of a lead pencil to pass. The man 
began taking large doses of Epsom salts to relieve the 
constipation. The quantity was gradually increased and 
other cathartics were taken, to such an extent that they 
had, at last, become inert; and he was necessitated to 
resort to enemas, although it was impossible for him to 
force much fluid through the narrow orifice. 

Examination disclosed the rectum filled with a semi- 
fluid mass of fecal matter, which was not apparent to 
the patient. He was in apparently good physical con- 
dition; but weak, and easily fatigued. Valvular insuffi- 
ciency and endocarditis were prominent symptoms. This 
man had been treated during eight years by electro 
physicians and membersi of all other "pathys. ,> His 
last doctor was an osteopath whose manipulations gave 
absolutely no relief, but on the contrary caused hernial 
rupture of a serious nature. 

(U) illustrates the ulcer; (B) the bladder; (G) gan- 
glia, controlling this part of the bowel; (C) spinal cen- 
ter of reflexes ; (S.T.) stricture; (0. P.) positions where 
they usually operate when resecting the bowel. 

It is exceedingly difficult for one not familiar with 
these troubles to diagnose them correctly, owing to the 
numerous valves at every turn and twist of this portion 
of the bowel, as illustrated by A, B, D, of Figure XXVI. 
(D) illustrates an extensive ulceration of the sigmoid, 
which occurs frequently just beyond the first curve of 
this organ. "When ulceration occurs at this point it 
invariably produces a close stricture. This stricture is 
very unyielding and persistent, because of the fact that 
the ulcerated surface is cut off by the stricture and ren- 
dered inaccessible to treatment, as the stricture is just 
below the ulcerated surface. There is also very grave 
danger of the local treatment producing inflammation 



248 

and spasm of this strictured portion of the bowel, so as 
to completely obstruct fecal discharges. Cathartics or 
any violent purgative are liable to produce the same 
condition. It is absolutely necessary to relieve this stric- 
tured portion of the sigmoid before remedies can be 
applied to the ulcer for its relief. There is a thick 
gelatinous mucoid discharge (at times attended with 
blood and pus) that escapes through the stricture from 




Figure XXVI. 



the ulcer. The source of this discharge has long been 
a mystery to both patients and physicians. It is rarely 
attended by any odor, and sometimes is so abundant as 
to cause a looseness of the bowels, to such an extent as 
to overcome the obstruction caused by the strictured 
condition. I am repeatedly asked, what causes this 
trouble? My reply is that I do not know; but I am 
inclined to believe that the abandoning of our old, 



249 

harmless, long-tried remedies, as castor oil and salts, 
for the various new tasteless compounds, are the most 
frequent causes. Many physicians doubtless recall the 
excitement and enthusiasm caused about twenty-five 
yearsi ago by a claim made by a physician who brought 
out a small book on "Orificial Surgery." In this book 
the author claimed to have cured practically all forms 
of chronic diseases, including "consumption," "rheuma- 
tism," neurasthenia, and other troubles by resecting or 
removal of about an inch of the lower rectum. The 
benefits derived from this operation evidently resulted 
from the removal of overticula and pus sacs along with 
the removed bowel. The operation, by shortening the 
tunics of the rectum caused a ' ' drawing ' ' sensation. 

Figure XXVI shows the valves (A and B) in the sig- 
moid; (D) shows ulceration. 

The upper and the lower portions of the bowel were 
brought in apposition as illustrated by Figure XXVII. 
The operation, however, usually results in complete 
closing up of the bowel, and an operation has to be per- 
formed for the formation of an artificial anus, as illus- 
trated in Figure XXVII. 



A 



^^ 




Figure XXVII. 



250 

"B" shows occlusion of bowel at the operation; "C" 
pedicle; "D" the old anus; the arrow indicating the 
direction of the feces down the descending colon, and 
out the artificial anus "A," on the left side, under the 
rib. 

Recovery from this operation was comparatively rare. 

Investigation resulted in discovering many of the same 
nature. There were also several cases where cauliflower 
growth extended almost entirely throughout the sigmoid 
flexure. Before meeting the before-mentioned case, my 
attention had never been directed to these particular 
lesions, except incidentally. Since then I have found 
that they are extremely common, and attended by almost 
every conceivable physical and nervous disturbance; 
paralysis, heart disease, neurasthenia, epilepsy, nervous 
indigestion, and constipation, are the most common 
sequelae of such lesions. 

Case 46. H. P. S., married, 86 years old, negative 
history, energetic. Consulted the writer about nine years 
ago for enlarged prostate. Cure of this was effected and 
nothing more heard from him until recently. He then 
informed me that after removal of the prostate trouble 
he had enjoyed excellent health in every respect until 
about six or eight months ago, when he began to suffer 
with constipation, indigestion and periodical pyrexia. 
He applied personally and said, ' ' As you cured me nine 
years ago of one trouble, I am now here to see if you 
can cure me of another that has not only annoyed me 
considerably, but has been so rebellious to the efforts of 
several other physicians that I have come to see if you 
can relieve me of it. The fever at first would begin 
about 4 P. M. and last until 9 P. M. Of late I am prac- 
tically never free from it, although it generally began 
to rise between 3 and 4 P. M., and reach its maximum 



251 

of 102-103F. by 9 P. M., then gradually decline, but 
would not entirely pass off before it would begin to rise 
again. ' ' 

In this instance the patient had dull aching sensation 
in the left hypochondriacal region, and this was most 
marked during the extreme pyrexia. The inflammation 
and tenderness gradually subsided upon the application 
of local remedies, was soon attended with defervescence, 
and ultimate cure after about three months of continuous 
treatment. By the latest advices he has moved to Cali- 
fornia and is now enjoying perfect health. 

Although there has recently arisen a campaign against 
cancer, those waging this war acknowledge that there is 
no theory yet advanced regarding its cause, diagnosis, 
and cure, that will bear examination. The only method 
of cure advanced consists of surgical procedure. If true 
cancer exists it must be admitted that the removal of any 
part of the growth does not remove the constitutional 
cause. Both local conditions and constitutional symp- 
toms should most prominently exist before any case can 
be truthfully diagnosed as carcinomatous or tuberculous. 
It is generally conceded that any surgical interference 
in true cancer simply aggravates the local conditions ; and 
the less there is of such interference the longer will be 
the life of the victim. 

The sigmoid-flexure is much more frequently prone to 
ulcerations and other similar disturbances than is gen- 
erally believed ; many prominent physicians consider it 
especially susceptible to carcinoma, and that the major- 
ity of such disturbances are cancerous. The writer is 
willing to concede that there are, say, two per cent, of 
these cases true cases of cancer in the sigmoid, but main- 
tains that not one-half of one per cent, of similar cases 
in the prostate and rectum are of that character. 



252 




Figure XXVIII. 



253 



LESION OF THE RECTUM. 



Figure XXVIII illustrates a very common lesion of 
the rectum which gives rise to more troubles directly and 
indirectly than any one would possibly imagine. Para- 
plegia of the left limb, constipation, epilepsy, indiges- 
tion, itching about the anus, nervous insomnia, and 
nearly every conceivable nervous disturbance has been 
traced to this trouble, and its removal has invariably 
resulted in the disappearance of these symptoms. 

The writer believes that the occurrence of any one or 
more of the before-mentioned symptoms is invariably 
accompanied by the presence of one or more of these 
overticula. Six of these overticula (or "pus sacs") have 
been found in one person. For their removal I have 
devised special instruments; without these instruments 
the operation is quite difficult. 

The cause of this particular lesion is very obscure. 
Its aperture is directed upwards as illustrated (showing 
hook entering it). The duct extends from the aperture 
downwards; and terminates in a blind cul-de-sac, near 
the anus. It is absolutely necessary to remove both the 
duct and sac, to effect a permanent cure. The ori- 
fice varies in size from one-sixteenth or one-eighth of 
an inch in diameter, or a little larger than a pin's head. 
They are very difficult to locate, as will be appreciated 
from my experience in endeavoring to point out the 
position of one to a physician who had made numerous 
attempts to find it in a patient whose symptoms indicated 
the presence of such a lesion. In giving a clinical dem- 
onstration to this physician, he remarked that he could 
now understand why he had hitherto failed to locate 
these lesions. He said it was due to the fact that "the 
landmark was so different from that which he had ex- 



254 

pected to find," as he was looking for a ronnd hole in- 
stead of a slit. The outlet of this particular lesion con- 
sists of a slit with a hole near its center. 

As a further illustration of the difficulty of locating 
these lesions by inexperienced practitioners, I may men- 
tion the fact that in a consultation with an old rectal 
specialist of thirty-five years' experience, he asserted that 
he had never seen or heard of such troubles. Though I 
endeavored to demonstrate to him the nature and im- 
portance of the lesion, he could never be induced to 
follow it up in his practice, although one of his own 
cases was entirely cured by myself of a serious nervous 
complication arising from one of these lesions that had 
resisted all his efforts for more than two years. Re- 
gardless of a favorable result in this case, he has never 
been able since that time to locate one in any of his 
other patients, although as before stated such lesions 
are quite common. 

They are specially irritating to the prostate and ad- 
jacent organs; in fact there are many cases or prostatic 
trouble that are so aggravated by these lesions that it 
is impossible to cure them until the lesions have been 
removed. 

It has been extremely difficult for me to demonstrate 
the presence and show the location of some of these 
lesions even to my own assistants. They have often been 
puzzled in tracing the duct leading from the orifice 
to the blind cul-de-sac, and instead of following the line 
of least resistance along the course of the canal to the 
bottom of this sac (which contains pus or sanguino- 
purulent fluid) they frequently simply pushed the hook 
beneath the mucous membrane, thus avoiding the natural 
channel and making a new channel, which procedure 
always fails to give relief, as the same old duct and sac 



255 

remains, secreting its poisonous fluid, which constantly 
saturates the vessels of the entire system with poisonous 
matter. 

Case No. 47. F. C. ; age 26 years; married; Swede; 
occupation, chauffeur; negative history; strong and 
robust up to two years since. At that time began having 
periodical attacks of typhlitis, varying at first from two 
to three months apart, then monthly. Would swell up 
with gas in both bowels and stomach and suffer intensely 
from pressure, constipation prominent symptom ; during 
first attacks was relieved by mild cathartic ; afterwards 
exceedingly strong purgative was necessary to obtain 
relief. Writer saw him during three of these attacks 
and insisted upon an examination, to which he finally 
submitted. There was but little prostatic irritation, but 
main symptoms and trouble were found in sigmoid flex- 
ure, examination revealing not only an ulcer, but marked 
closure, the lumen of the bowel being not more than one- 
third of normal. This condition grew worse from day 
to day until an attack precipitated an unusually violent 
distention of the bowels, and another physician was 
called, the patient not being where the writer could be 
consulted. This physician diagnosed his case as acute 
indigestion and remedies therefor were given with nega- 
tive effect. A second physician was called in consulta- 
tion, when it was decided to examine the blood, and await 
developments. Microscopic examination of the blood was 
negative. This procedure was continued daily for three 
weeks, the only treatment attempted being the adminis- 
tration of ten drops of tincture of opium, with beef tea, 
in rectum, every two hours, both day and night. The 
man grew worse steadily, and the writer was called to 
see him in consultation, by his wife. The physicians in 
attendance were reminded of the fact that cathartics had 



256 

formerly given relief, and of the condition of the sig- 
moid. However, the writer was overruled ; and, owing to 
the long continued swelling and exceeding tenderness of 
the abdomen, the attending physicians both diagnosed 
the man's ailment as "primary peritoneal tuberculosis/' 
and insisted that microscopical examination revealed this 
fact, and decided to continue their opiates and beef tea 
with examination of the blood and await the result. 
I told his wife that there was absolutely no chance for 
him to recover under his present treatment; but as the 
other physicians had the case I could do nothing. She 
was greatly distressed and finally, after two weeks (her 
husband growing worse all this time), dismissed the at- 
tending physicians and had me called. The whole abdo- 
men was greatly swollen, the peritoneum involved, and 
so tender that he could not permit the slightest percus- 
sion without much suffering. My first efforts were di- 
rected to evacuating the bowels by administering minute 
doses (one-tenth grain) of calomel, and one grain of 
bicarbonate of soda every hour during the day. The 
opiates were discontinued. He had been given them 
day and night for five weeks. He became so extremely 
nervous from the cutting off of the opiates so sud- 
denly, that I was necessitated to give him small doses 
of them before stopping them altogether. On the fol- 
lowing day, an enema was given of a special prepara- 
tion, that caused him to pass very large quantities of 
lumpy offensive fecal matter, that had evidently been 
locked up a month or two, if not longer. While he was 
being given the opiate and beef tea there was a continu- 
ous fluid discharge from the bowel, with very little fecal 
matter, and it was impossible for me to convince the at- 
tending physician that any still remained in the bowels 
At this time the man could not stand alone nor could 



257 

he walk across the room, being so weak. He had a con- 
stant hectic cough, considerable expectoration, and tem- 
perature ranging from 102 to 104. Defervescence gradu- 
ally took place, until three days later he was devoid of 
fever and taking nourishment. A week after this, he was 
at my office under treatment, being carried there in an 
automobile. He rallied very rapidly, cough disappeared, 
Strength gained, yet the peritoneum remained tender 
several weeks. He had by this time gained so much in 
strength and health that he insisted upon resuming his 
work as a chauffeur, and made application for such 
position. At this time I left the city for my annual 
vacation, turning the man over to my assistant. On re- 
turning two months thereafter, I learned he had relapsed 
and was again confined to his room, being treated by a 
Swedish physician, who diagnosed his trouble as tuber- 
culosis, and promised to cure him in six weeks. The 
wife being a Swede, had confidence in her physician, and 
insisted upon his continuing with the case. The young 
man died a few weeks later from profuse hemorrhage. 
I never learned whether the hemorrhage was from his 
lungs or his heart, but believe that it wasi due to the 
latter, as he suffered with marked endocarditis in con- 
nection with his other troubles. 

Case 47. J. B. A., aged 60; married; four children; 
negative history; farmer. Although thin and delicate 
in appearance, he was very active and strong, being able 
to do a great amount of manual labor. He had been 
slightly costive for several years, and had noticed some 
trouble since then. On arising in the morning and at 
stool when attempting to leave, he noticed that he lost 
the use of his left leg. He managed to return to his 
room and called an attendant, and afterwards a physi- 
cian, who examined him and diagnosed his condition as 



258 

"blood poison.' ' The left limb was very much swollen, 
considerable varicose disturbance with some pain 
throughout the calf of the leg, the popliteal space, and 
the inner side of the thigh. The writer wasi called in 
at the time, and upon examining the patient in con- 
junction with this physician, told the latter what he 
suspected was the cause, and insisted upon the patient 
returning to his office. A "py-ro-sak" was removed 
and in three days thereafter, he was walking as well as 
he ever did, with the exception of some little soreness 
in his limb. He recovered fully, and has gained fifteen 
pounds in weight and is better than he has been for 
twenty years. A fourth very similar case to this oc- 
curred in a man of 40 years of age — had been bookkeeper 
practically all his life, and was relieved as quickly and 
as permanently as the patient just spoken of. 

Case 49. F. W. B., age 23; single; negative history. 
Office man. Very constipated from early boyhood, and 
often experienced pain after stool. Four years prior 
hereto, he began noticing some pain in voiding urine. 
His general health began declining, attended with py- 
rexia, slight headaches and irritative cough, which had 
been termed "bronchial cough." This cough at times 
would become so excessive as to cause soreness and some 
purulent secretion, but very little. The last physician 
had pronounced it ' ' tuberculosis, ' ' and several examina- 
tions by different bacteriologists reported "tubercular 
bacilli." The patient was not satisfied with one, two or 
three of these examinations, but had them made in dif- 
ferent sections of the country with a history of the case, 
until he had finally been convinced that it was "tuber- 
culosis." Upon examination I discovered slight pros- 
tatic irritation, and irritation of the vesical neck, which 
yielded readily to treatment. Further examination of 



259 

the rectum located one after another of py-ro-saks, until 
it seemingly was - ' honeycombed ' ' with these. Nine were 
removed in succession before any marked relief had been 
procured. These had evidently been present for several 
yearsi, and had caused the extension of the irritation 
and inflammation until the sigmoid-flexure was almost 
entirely occluded. The relief of this latter completely 
removed the cause and cured his " tuberculosis. ' ' He 
has not had any cough or any expectoration since, except 
Occasionally when he has a slight cold. 

A year thereafter he began having symptoms of ap- 
pendicitis, pain in the right hypochondriac region every 
afternoon, which finally culminated in paroxysms of 
fever. This fever continued to increase until it would 
reach 102 F. each afternoon, often attended with head- 
aches, pyrexia, and general depression. Defervesence 
would take place at about 9 or 10 o'clock in the evening, 
followed with profuse perspiration and very marked 
depression. He would scarcely recover from one attack 
before experiencing another. He continued to grow 
worse for ten days, when he again consulted the writer. 
The pain in the region of the appendix was most marked, 
and attended with throbbing sensation, as though puru- 
lent secretion had formed. Examination again revealed 
acute inflammation and nearly complete occlusion of the 
sigmoid-flexure. Relief of this restored the patient to his 
normal condition, and he has not had another attack 
since — more than a year ago ; in the meantime he has 
gained forty pounds in weight, and reports that he is 
perfectly well in every respect. 

Case 49. K. A. B. Age 33 ; single ; negative history ; 
temperate habits, very delicate, thin and emaciated; 
constipation and anorexia, urine murky, with heavy 
deposit, alkaloid, hyaloid, mucoid casts; no tube casts; 



260 

no albumen; slight trace of sugar; blood count sixty; 
suffered intensely with back and limbs, voiding urine 
very frequently, scanty, and with much tenesmus. Rec- 
tum very tender ; sigmoid ulceration and stricture. Had 
been afflicted for more than twelve years, and treated 
during that time by one of the most eminent specialists 
in city of New Orleans, and by specialists in other large 
cities; no relief. Examination and first treatment re- 
quired hour and a half, so extensive was the ulceration 
and granulations and the almost entirely closed condi- 
tion of the sigmoid. This case was* very tedious and slow 
in recovering, with periodical return. Some weeks 
greatly improved, and other weeks suffering intensely. 
These conditions continued for two months when he re- 
turned home in fair health, apparently. Became worse 
and returned. At this time he began suffering with his 
limbs, feeling heavy and weighty, with indications, as 
he feared, of paralysis. This suddenly subsided upon 
treatment and he began improving rapidly. Again re- 
turned home, feeling well. Six months afterwards there 
was a recurrence of the trouble, though not so marked 
as the first. Lived in the South in a very low and 
unhealthy locality, to which fact I attribute much of 
his ill health. On one occasion, after using an enema, 
he voided a large quantity of lumpy, offensive fecal 
matter, as he described it. He passed probably a quart 
or more, and upon getting into bed, was compelled to 
get up a second time, when he passed as much or more 
of this matter as he did at first ; and then had passages 
a third, fourth and fifth time, at intervals of from a half 
hour to an hour, having voided, as he thought, in all, 
more than a water bucket full of this lumpy, offensive, 
fecal matter. Immediately following these passages he 
became ravenously hungry ; and though it was midnight, 



261 

and the first time in years that he had had such desire, 
so great did it become that he left his bed and went to 
a restaurant to satisfy his appetite. On the following 
day he experienced the same very great desire for food, 
and felt much relieved of all his diseased conditions; 
from that time on his improvement was unusually rapid. 

Case No. 50. V. A. T. Age 32. Bank clerk ; small in 
stature; very thin, weight only 126 pounds; extremely 
nervous and restless, insomnia, indigestion and consti- 
pation; irregular heart action; for a year prior to this 
he had become so exhausted that he was compelled to 
give up all forms of work. Was treated for six months 
for stomach trouble, having stomach washed out, and 
taking various digestives and mild cathartics. Also suf- 
fered with stricture of urethra and swollen prostate, 
necessitating his getting up from three to five times at 
night, and very frequent urination through the day. 
Suffered also with backaches, headaches, pains in his 
limbs, at times causing a heavy, dragging sensation, as 
if limbs were too heavy to be raised, resulting in stumb- 
ling in going up and down stairs, causing him to fall 
on one occasion ; also pricking, tingling sensations along 
the sciatic nerves, down to calf of legs, on the inside, 
especially in left leg; also a creeping or drawing sensa- 
tion across the abdomen, and itching about the rectum. 
Very close stricture of and sensitive sigmoiditis, neces- 
sitating large doses of cathartics to effect evacuation. 

There were so many complications, and he was in such 
a low state of health, that improvement was very slow 
and attended with many ups and downs for six or eight 
months before entire restoration. It has now been two 
years since treatment, and he has gained 26 pounds in 
weight, and is back to his position, working daily, with- 
out a single symptom of his former trouble. 



262 

Case 51. A. J. B., minister, 56, negative history, mar- 
ried ; up to his fortieth year was in perfect health, then 
began suffering with indigestion and constipation. Three 
yearsi before consulting the writer, he began to be 
troubled with loss of use of left side. This grew gradu- 
ally worse until one day at stool he fell off the commode 
and was unable to walk on account of the left limb being 
paralyzed. Examination revealed varicose enlargement, 
and involvement of the sciatic nerve. He also had ex- 
ceedingly sensitive rectum. A "py-ro-sak" was located 
and removed. Improvement at once began, and six 
months thereafter, one could not notice any defect in his 
gait. 

Case 52. W. J. H., aged 56, negative history, married, 
several children. He suffered with chronic enlarged 
prostatitis and cystitis, also endocarditis and leaking 
mitral valves, complicated with excessive cauliflower ex- 
crescence throughout the sigmoid-flexure. The man had 
been in this condition practically for ten years, gradu- 
ally growing worse all the time, until finally he became 
confined to his room, and in bed most all the time. Treat- 
ment allayed the trouble with his prostate and bladder ; 
but he continued to suffer with the sigmoid-flexure, and 
with extreme constipation. His former physicians had 
given him large quantities of opiates, to relieve his suf- 
fering. These were discontinued after he fell in my 
hands, although he was constantly begging for them. I 
think he was taking them clandestinely during all this 
time, although he denied it. He gained very much in 
general appearance and in flesh, while under my care; 
but after treating him continuously for three months I 
was compelled to dismiss him, still suffering with alter- 
nate constipation and colliquative diarrhea. At times his 
appetite was ravenous, and he seemed to digest his food 



263 

well; at other times lie complained of not being able to 
eat anything. 

As his improvement at first was rapid I believe he 
would have been restored to perfect health had he con- 
tinued the treatment, and had not his wife been secretly 
supplying him with opiates. 

He is at this time confined to his room and remains 
about the same in health. His disease had been diag- 
nosed as cancer, yet he has persisted in about the same 
condition so long that I question whether there is any 
carcinomatous complications attending it, as the symp- 
toms do not indicate such. 

Case 53. Miss K. V. H., court stenographer, aged 32, 
had led sedentary life for fifteen years. Suffered with 
headache, indigestion, extreme constipation, excessive 
neurasthenia. Well developed physically, though of an 
unhealthy appearance. Insomnia was quite marked; so 
affected her as to make it extremely difficult for her to 
hold her position. The headaches were almost continu- 
ous throughout the day and often lasted late into the 
night. She stated that she would often lie awake more 
than one-half of the night using every effort to induce 
stupor. 

The constipation during the first year was relieved 
by mild cathartics ; it gradually grew worse, until finally 
large doses of the cathartics were unable to effect evacu- 
ation of the bowels; the medicines would give rise to 
tenesmus and colicky pains. Her position in this re- 
gard, as she stated, was becoming desperate, and she 
did not know what it would result in. She also tried 
enemas, but the medicated water used would not enter 
the upper bowels, but immediately flowed out. During 
the last six or eight months every effort to flush the 
bowels by enema was attended by failure, as she was 



264 

unable to get the medicine to pass beyond the sigmoid- 
flexure. This lady was a patient of Dr. "W. A. Hanor, 
who had managed her very nicely until he found that 
it was impossible for him to evacuate the bowels by any 
ordinary means. 

Physical examination revealed a closed stricture of the 
sigmoid-fiexure, complicated with extensive cauliflower, 
growth and ulceration. Although this would seemingly 
be painful, yet there was no distress of any kind in the 
region of this lesion, except when applications were 
made directly to the stricture and ulcerated part, in 
efforts to relieve it. Treatment of this case was made 
by Dr. Hanor under the author's special directions and 
advice, and resulted in very rapid recovery and perfect 
restoration to normal conditions in evacuating the 
bowel; relief from indigestion, headaches and insomnia, 
at the expiration of three weeks' time. Nine months 
has elapsed and she still reports being in perfect health, 
and says that it is difficult for her to get enough sleep 
now, as she is making up for the sleep lost during the 
years she lay awake. 

Case 54. A case presented in December, 1911, with 
such obscure, subjective symptoms that it brought about 
thorough research, which ultimately developed in the 
unraveling of a chain of objective symptoms, and the 
unearthing of several obscure lesions, which, together 
with those heretofore made known, has solved the great 
problem of the causes of from 80 to 95 per cent, of all 
chronic diseases, and the perfecting of special remedies, 
and methods for their cure, will, inevitably, revolutionize 
the practice of medicine. 

The case in point was that of a man of 32, no venereal 
history, single, temperate, nervous, restless, insomnia, 
melancholia, wild-eyed, alternately pale and flushed face, 



265 

pain in calf of leg, big toe and back, dizziness, floating 
spots before eyes, but with little or no vesicle irritation. 

He had consulted the best medical talent in the East, 
including New York, Washington, Baltimore and Phila- 
delphia, for four years. He first sought a nerve special- 
ist and then a rectal specialist, then a genito-urinary 
specialist. He grew worse, daily, and, being an intelli- 
gent man and afraid of himself, he had his family phy- 
sician go around with him. After four years 9 rounds 
he was advised to go to a special rectal specialist in Kan- 
sas City. He was treated there for six weeks by this 
last specialist with the same result that he obtained from 
those in the East. The latter having exhausted the man's 
resources sent him to the writer. 

Examination of the prostate revealed it to be normal, 
excepting slight hyperesthesia. Three days' treatment 
of the prostate gland, with negative results. Insomnia, 
melancholia, and his nervous condition worse, as he had 
hoped for, and had been promised, much relief. An- 
other thorough exploration revealed the source of his 
trouble, which will be thoroughly described and illus- 
trated in the supplementary volume together with de- 
scription of the instruments devised by the writer for 
the relief of such cases. It is almost impossible to 
describe these thoroughly without illustrations both of 
the instrument and the lesion. 

The writer had much trouble in finally removing this 
lesion, as he did not at that time have instruments 
suitable for such cases, and was necessitated to devise 
special instruments for this temporary purpose. Under 
these circumstances the case was quite difficult to relieve. 
The removal of the reflex exciting causes restored tran- 
quility to the sympathetic ganglion, vaso-motor system, 
and cerebro spinal system. The long pyogenic saturation 



266 

of the blood, and the equally as long excitation of the 
two nervous systems had existed until the man 's physical 
and nervous condition were almost in a state of collapse ; 
yet he responded immediately to the treatment, and was 
soon able to return home in perfect health. 

Case 55. "W. B. C, Student, aged 24, single, no 
venereal history ; somewhat similar to the preceding case, 
except that he complained of dizziness, almost falling 
upon the street, unless leaning upon a post, wall or 
house or sitting down. Specks before the eye, mild 
epileptic attacks, sluggish memory and headaches. 
Glasses had been fitted by different opticians. Little 
relief. Up to his seventeenth year he was perfectly 
well, but at that time he had to discontinue school. 
Fairly comfortable for three years and returned to 
school at 20. Headaches;, dizziness, and all of the old 
symptoms returned. Very ambitious and continued 
school, having his roommate read for him. These irregu- 
lar attempts at education continued for four years, when 
he consulted the writer. His condition vacillated; some 
days he felt well, others worse, until he at last discon- 
tinued treatment. At the expiration of two months he 
returned, when another examination revealed a second 
and third lesion in succession, which were more diffi- 
cult to locate and reach for treatment. After their 
removal, he stayed quite a while, but no other lesion 
.could be located at that time. This doubtless, was due 
to the fact that he still had the impression that he had 
consumption, or tuberculosis, as he had been so thor- 
oughly convinced of this fact by his former physician; 
besides, the cough and weakness continued uninterrupt- 
edly, if not even worse. 

Thorough additional exploration revealed a fourth 
pathologic condition. It was necessary to devise special 



267 

instruments for the treatment of this trouble, and, as he 
had been so thoroughly convinced by his family physi- 
cian that it was* useless to attempt any further treat- 
ment, he was also advised that on account of the incur- 
able "consumption," and the necessity of changing cli- 
mates, it was quite difficult for the writer to persuade 
him that it was possible for him to be cured, although 
his cough had continued uninterruptedly up to this time. 
He finally consented to further trial. At the expiration 
of two weeks' time his pulse was reduced to 82 from 
100 and above ; his cough was much improved, his appe- 
tite had returned, the gases in his stomach were dimin- 
ished, and he had become much encouraged. 

The long continued illness and the thorough satura- 
tion of the blood with various purulent bacteria ren- 
dered his recovery very slow, and it was four months 
thereafter before he was dismissed as cured. 

The man returned to his work and improved slowly 
though gradually, regardless of being confined closely 
at business, until he gained 32 pounds in four years. 
Since his dismissal, four months ago, he has married; 
and has been in excellent health and condition ever since. 
Prior to his marriage he insisted upon undergoing a 
thorough physical examination to determine whether or 
not he was in a fit condition for the marriage state. 



CHAPTER VIII. 

TUBERCULOUS, SYPHILITIC PROSTATITIS, CYSTITIS, 
VESICULITIS, ETC. 

Little mention has been made by authors of syphilitic 
prostatitis. I, too, had overlooked it as a prominent 
etiological factor of prostatitis until two very charac- 
teristic cases had come under my observation. There is 
no reason, to my mind, why the prostate should not 
become subject to the influence of constitutional syphilis 
as well as the testicles. All cases of syphilitic prostatitis 
that I have noted have resulted from the tertiary form 
of the disease. 

Case 56. Aged 54 ; single ; sailor. He had had several 
attacks of gonorrhea, the first at about twenty. At 
about thirty he had syphilis. He had no recollection 
of secondary symptoms. He took constitutional treat- 
ment for only about six months, and then not regularly. 

There were blotches upon the lower and outer portion 
of his shin bone, simulating syphilides. His rectum was 
badly ulcerated, extending about three inches from the 
anus. The prostatic urethra was excessively tender. In 
fact, he had most of the symptoms attendant upon 
chronic enlarged prostatitis. The acute prostatic symp- 
toms were allayed for a time by ordinary means; but 
the indications were so prominent of contitutional syph- 
ilis that he was placed on treatment for that disease, 
ignoring the local condition of the prostate. His im- 
provement was so marked that I was convinced that the 

268 



269 

larger portion of his prostatic troubles were due to syph- 
ilis. There were many ups and downs attending the cure. 

TUBERCULOSIS OF THE PROSTATE. 

Of all diseases of the genitourinary organs, it requires 
greater elasticity of the imaginative faculties to diagnose 
this form of disease of the gland than that of any other 
organ of the body; yet there are writers who describe 
accurately the tubercular nodules which they think they 
have detected by examination through the rectum. Of 
late I have come to look upon "tubercular prostatitis" 
only as a loop-hole through which to escape the re- 
sponsibility of failure to relieve an intractable case of 
chronic prostatitis by the means usually in vogue — 
namely, the sound, cautery, massage. 

The diseased prostate, as much or more than any other 
organ of the body, often provokes mental and physical 
depression, which results in emaciation, a hacking cough, 
and prepares favorable soil for the development and 
propagation of pulmonary tuberculosis. Many of such 
cases have come under my care that have yielded readily 
to treatment of the gland, and restoration to perfect 
health followed. 

ASPERMATISM. 

This is a peculiar and rare condition, in which there is 
a competent erection, and, at times, a slight orgasm, 
without ejection of semen. Taylor says: "Lesion of the 
prostate being so often the cause of aspermatism, I al- 
ways advise an examination of the gland through the 
rectum." He claims also that aspermatism is caused by 
the ejaculatory ducts becoming plugged up by sympexia, 
preventing thereby the escape of the semen into the 
urethra. He mentions a typical case, as reported by 



270 

Beliquet, where relief followed the escape of a large 
quantity of sympexia through the urethra. Occlusion 
of the ejaculatory ducts by prostatic calculi has been 
reported by different authors. 

I have observed two cases of aspermatism following 
chronic prostatitis, one of which was of especial interest 
owing to some novel symptoms connected therewith. 

Case 57. A young man, thirty-two years of age ; single, 
traveling salesman. He had been very dissipated for ten 
or twelve years by way of hard drinking and excessive 
sexual indulgence. He rarely became intoxicated, how- 
ever, but drank continuously. He had had gonorrhea 
quite often, followed by gleet; with which he had suf- 
fered for the past ten years. During one of these 
carousing bouts he was stricken with paraplegia and 
incontinence of urine. He had been in this condition 
for twelve hours before I saw him. The urine was 
passing involuntarily from overflow of the bladder, 
indicating paralysis of sphincter urinae. 

Relief of the acute symptoms was soon effected. On 
his abandoning whiskey his improvement began at once ; 
and at the expiration of two months he was able to 
stand on his feet and pass urine normally. He went 
home and I did not see him again for more than a year, 
when he came to my office walking with a cane. He 
laid his cane aside to show me that he was not forced to 
use it; there was but little indication of his former 
paralysis. He reported that he had had no trouble in 
voiding urine for some months; but that one peculiar 
symptom was that he was able to have an erection and 
intercourse normally without passing semen, and with- 
out any sensation in the way of orgasm. He also stated 
that the erection could be produced at will and main- 
tained for an indefinite period, often several hours, 



271 

enabling him to complete the act of intercourse several 
times with no ill effects except prostration from physical 
exertion. I have heard from him several times during 
the past five years. He reports his condition about the 
same as when he saw me last. His health otherwise is 
good. 

Case 58 was that of a man of forty-eight years of 
age; married; very corpulent; healthy and in perfect 
condition up to two years before seing me. He had 
then begun to suffer with chronic enlarged prostatitis 
and from that time was totally impotent, manifesting 
all the symptoms usual in such cases. He was treated, 
and practically relieved of the symptoms. There was 
a normal recurrence of the functions of the sexual or- 
gans, enabling him to have intercourse without discom- 
fort. About a year thereafter, he reported to me that 
he had begun to have trouble in the way of lack of 
emission of semen during intercourse. It would pass 
to about midway of the urethra, where it would stop, 
apparently from lack of force in the muscles to expel it. 
There was slight orgasm during the ejection. 

There are other cases of aspermia that result from 
occlusion of the ejaculatory ducts as result of cicatrix 
following prostatic abscess; other cases have been re- 
ported where the ducts were closed by prostatic calculi, 
thereby obstructing the passage of semen. 

CHRONIC PRIAPISM. 

Chronic Priapism. Chronic priapism is due most 
frequently to an acute inflammation of the pros- 
tate and prostatic urethra. While the initial causes, in 
most instances, of the inflammatory conditions are the 
same, yet it is often found that these have been aggra- 



272 

vated by the use of sounds, caustic applications of the 
deep urethra, or other violent measures. 

The localized inflammatory focus, situated usually in 
the prostate and caput gallinaginis, reacting upon the 
sexual brain through the prostatic ganglion and inde- 
pendently of mental influences, causes prolonged irrita^ 
tive erections that are exceedingly wearing upon the 
nervous system. These distressing erections more fre- 
quently occur during sleep, arousing the man by their 
irritative effects, and disturbing his sleep for hours at 
a time. Paradoxical as it may appear, men so affected 
are generally impotent and are incapable of obtaining 
an erection under normal influences. There are others 
similarly affected where one sexual congress only inten- 
sifies the desire for a repetition, which is repeated until 
complete mental and physical collapse results. 

More recent clinical observation has demonstrated to 
the writer that sigmoiditis, whether due to ulceration, 
or to a stricture of the latter organ, is the chief etio- 
logical factor of priapism. These observations have 
shown that relief of the sigmoiditis has entirely removed 
the priapism. This did not occur in an isolated case; 
but numbers of such have been met with recently, and 
cases which the writer failed to relieve many years ago 
have been notified of recent discoveries and have since 
been cured of this annoying depressing trouble. 

One reason why sigmoiditis or other lesion of the sig- 
moid give rise to priapism is because the nerve center 
controlling this organ is in close proximity to the genito- 
spinal center. Again, the location of the pain in the back 
caused by disturbances in the genito-spinal center where 
prostatic trouble exists, is in such close proximity to the 
location of the pain arising from lesion of the sigmoid 
that they are practically in one and the same place. 



273 

There is no disturbance to which man is subject that 
is sc wearing and annoying as priapism. 

CHRONIC PRIAPISM. 

Case 59. Man, aged fifty-four; healthy from all ex- 
ternal appearances ; very temperate and a good business 
man. He had had one attack of gonorrhea, from which 
he had apparently recovered. For four years he had 
been annoyed with persistent erections at night, which 
would often last two or three hours at a time, necessi- 
tating getting up and walking the floor to get relief. 
On attempting intercourse there was a complete col- 
lapse of the organ and utter failure, regardless of all 
efforts and remedies used for the purpose. 

He had been subjected to the use of sounds, aphrodi- 
siacs, bromides and massage of the prostate without 
benefit. 

Case 60. A minister, bachelor, aged forty-two, and 
an exceedingly intellectual man, consulted me for chronic 
priapism. He had been annoyed with the erections for 
about five years. At firsit, it only disturbed him at 
night, but for the past three years it had annoyed him 
both day and night. He had consulted many physicians 
regarding the trouble, and several had given him differ- 
ent forms of bromides, which, as he said, had only served 
to impair his mental faculties, without giving any relief 
to his embarrassing condition. He requested me not to 
give him anything that contained any of the bromides, 
as it was necessary for him, in his line of work, to 
maintain an active brain. He further stated that these 
erections often remained hours at a time, even during 
the day, which maintained the organ in a tender and 
often painful condition. He stated that he had lived 



274 

a perfectly virtuous life; and there was no reason to 
question it. I explained to him that the symptoms indi- 
cated a local inflammation of the prostate and adjacent 
organs, and that systemic medication could never relieve 
it. The gland was very sensitive, and quite rebellious 
to treatment, owing, doubtless, to his abstemious habits. 

Case 61. Physician ; single ; age thirty-eight ; never 
had gonorrhea. He began having trouble when about 
twenty years of age. He was treated with sounds at 
first, without relief, then injections and systemic medi- 
cations. "For the past twelve years," as he states, "he 
has been tortured with erections, the organ remaining 
erect for hours at a time. There has also been a slight 
urethral discharge for fifteen years; at times it is 
scarcely noticeable. Seminal emissions, too, occur, at 
times, even two or three within a week, then again not 
for a month. Emissions now occur without much sen- 
sation. They make me dreadfully weary, causing pain 
in back, and back of neck. I can't stand mental work, 
and my memory, I find, is perceptibly failing. I have 
treated myself, and was treated in New York by two 
physicians for two years, one of whom gave me bromide 
of sodium and ergot for the annoying erections without 
the least benefit. The other used cold sounds and mas- 
sage of the prostate — all of which gave no relief." 

In cases of this nature the prostatic urethra and the 
gland itself are very tender and much inflamed, on the 
relief of which, all other symptoms are allayed. 

MARRIAGE. 

The question of when a man should marry, who has 
had chronic gonorrhea, prostatitis or any perverted 
sexual function, is one of paramount importance, and 
has elicited much discussion and various expressed opin- 



27 



.j 



ions among genito-urinary; specialists throughout the 
world. 

Men suffering from one or more of these troubles are 
frequently advised to marry before procuring relief, 
which has entailed untoward misery, unhappy unions 
and often separation. This subject was discussed at 
great length at the Sixth Congress of the German Derma- 
tological Society, at Strasburg, in 1898, and it was the 
concurrent opinion of those present that just so long 
as gonococci could be detected in the secretions, they 
were infectious. 

One other point upon which all agree is that the 
gonococci do hide and remain dormant for an indefinite 
period within the prostate and adnexa ; and, while it has 
been proven that these germs are especially susceptible 
to germicidal agents when brought into direct contact 
with them, how are you going to reach them ? As Weiss 
says: ""What means do we possess to entice these para- 
sites to the surface ? ' ' There is no means known to the 
profession of enticing them from their hiding places, and 
the only way to get rid of them is to destroy them 
within the gland. 

There are other diseased conditions of the prostate, 
however, not dependent upon gonococci, that it is equally 
as essential to relieve before marital relations should be 
advised. The cause and treatment of these have been 
given in a previous chapter. 



CHAPTER IX. 

NEUROSES OF THE PROSTATE AND ADNEXA. 

The sexual organism, of which the prostate is one of 
the chief factors, is so intimately blended with the cen- 
tral and sympathetic nervous systems, that disease of 
this gland provokes the most varied neurotic disturb- 
ances. 

The lumbar spinal center, sacral plexus and great 
sciatic nerve of the cerebro-spinal system, and the hypo- 
gastric plexus of the sympathetic, are in such close 
reciprocal relation to the nerves of the prostate, that 
disturbances in the organs to which the former are 
distributed are frequently the first precursors of disease 
of the gland. 

Often have I seen men who had been dosing their 
stomachs for dyspepsia, their livers for torpor, their 
bowels for constipation, their heads for neuralgia, treat- 
ing sciatica for malaria, plastering their backs for 
Bright 's disease, taking sea voyages for melancholia, 
when the origin of their trouble was centered in the 
prostate, or adjacent organs, the relief of which cured 
their other ailments. There are many of these cases, 
too, that have no subjective symptoms pointing directly 
to disease of the gland, yet upon examination the objec- 
tive symptoms would be most marked. 

The erroneous idea, that prevails among many phy- 
sicians, and the majority of laymen, that disease of the 
prostate only results from some venereal disease, or is 
a sequel of senility, deters them from an examination of 
the gland for these obscure troubles. 

276 



277 

NEURASTHENIA. 

This is one of the most prominent symptoms in dis- 
eases of the prostate and is manifested in almost every 
conceivable form of nervous disturbance. The disease 
so commonly referred to as "nervous prostration" 
might; in the large majority of instances, be traced to 
the prostate, should the attending physician take the 
care to examine the patient for this trouble. The ex- 
amination is easily made; and even should such trouble 
not exist, it is better to be aware of the fact, and so 
dismiss one probable etiological factor, than to continue 
groping in the dark and dosing the patient "ad 
nauseam." Because of the almost universal opinion of 
both doctors and laymen, that to suggest disease of this 
gland would imply that at some time in life the patient 
had had some form of venereal disease, the physician is 
loth to make such suggestion. And, even should he 
muster courage to do so, he would, in all probability, 
be met with the prompt reply, "Why, doctor, I never 
had any disease there in my life." It has been difficult 
for me at times to convince people that these troubles 
are not always the result of venereal disease. But, when 
the patient understands that the doctor's desire to know 
positively that no such disease of the gland exists, is in 
order to discard it as a possible cause, the patient will, 
in almost every case, submit to an examination; and, 
by means of the bougie a boule the trouble in the pros- 
tatic urethra will be detected. The examination through 
the rectum or by cystoscope could be made at the time, 
or on some other day, should objection be made. Many 
cases of nervous troubles of an obscure origin have been 
cleared up in this way. 

Sexual neurasthenia is not an idiopathic disease, and 



278 

rarely, indeed, can it not be traced to the prostate or 
genital organs as the prime cause. 

I remember hearing a lecturer, at the Blockley Hos- 
pital, Philadelphia, say that he had often declared that 
he would not vote for any man to graduate in his class 
who failed to suggest examination of the prostate in 
answer to the following question: "What would you 
do if a man presented himself with an obscure nervous 
disease ?" At the time I considered the statement ab- 
surd — especially as the lecturer was not a Jefferson pro- 
fessor — but I have since often thought it a very wise 
utterance. 

Genito-urinary diseases of men as results of pros- 
tatitis and the various functional nervous disorders 
related thereto, whether as cause or effect, are in the 
same condition that diseases of women were in fifty 
years ago. At that time the nervous symptoms that ac- 
companied such disorders in females as lacerations of 
the cervix or perineum, congestion and displacement of 
the uterus and ovaries, were succinctly, if unscientifi- 
cally, grouped under the head of hysteria, and these 
symptoms treated without reference to the cause and 
often without the least effort to arrive at a correct diag- 
nosis. And today the nervous maladies resulting from a 
morbid condition of the prostate gland and adnexa, such 
as mental depression, morbid fears, nervous dyspepsia, 
palpitation, deficient mental control, headache, and back- 
ache, are generally dismissed in the same easy fashion 
to the category of hypochondriasis. 

Considering the immense importance of the problem 
involved in the relation of the genital function to the 
nervous system, and the vast amount of suffering en- 
tailed upon mankind by the ignorance of the patient 
and the indifference of the physician in regard to these 



279 

problems, remarkably little effort has been expended 
towards their solution. Whether there is or is not such 
a disease as spermatorrhea, and if there is, what is its 
nature and effect ; when are involuntary emissions patho- 
logical; what are the various kinds of impotence, and 
how should they be treated; how are morbid conditions 
of the prostate gland and urethra reflected to the nervous 
system; how do nervous and other diseases affect the 
genital functions? — these and other problems of great 
practical interest have only within very recent years 
begun to attract the attention of the investigator, while 
the profession at large is as yet almost blind to their 
importance. 

These conditions have been thoroughly described and 
illustrated in a previous chapter ; and if the reader will 
take the trouble to refer to it, and read the matter over 
carefully, these different reflexes will be made clear and 
plain to him. 

While the excitant cause of sexual neurasthenia is 
traceable in the majority of instances to disease of the 
prostate and adjacent organs, yet there are other exacer- 
bating etiological factors that must be taken into con- 
sideration. Prominent amongst these are excessive smok- 
ing, alcoholic stimulants, business cares, domestic wor- 
ries, climatic conditions and overtaxation of the mental 
faculties. All these have been taken into account as 
concomitant factors in genital neuroses. While the pro- 
fession and many laymen attribute much of these dis- 
turbances to the before-named as the chief causes, yet 
the writer believes, that Avith the exception of alcoholic 
stimulants (and possibly smoking) none of them cause 
this particular class of nervous disease, or at any rate 
not to that extent as to require treatment ; except when 
the condition is induced primarily by lesions of the pel- 



280 

vie organs. So often have these been detected and 
relieved, and the relief has been followed by the re- 
moval of abnormal nervous conditions, that the writer 
considers it extremely seldom that any serious nervous 
disorder arises independent of these local lesions in 
either men or women. 

The symptoms of sexual neurasthenia are so protean 
in nature, that, according to the prominence of one or 
other stage of its development, it is frequently diasnos- 
ticated as oxaluria, lithemia, or disease of the imagina- 
tion. 

Its real and tangible cause isi either overlooked, or an 
attempt to discover its source altogether neglected. The 
physician is usually content to guess at the cause, pre- 
scribe some innoxious remedy, and await the result. 
Others resort to nux vomica or its alkaloid, combining 
or alternating it with various other aphrodisiacs, which 
tend to excite an already tender or diseased prostate. 
The man returns from time to time and reports some 
better, then worse ; when, in fact, he is growing gradu- 
ally worse all the time. This condition may continue for 
a long time, until the man finally becomes aware of a 
twitching of the muscles of the lower limbs ; in others the 
fingers tingle, or there is an impairment in the use of 
an arm, noticeable in writing or handling a knife or fork 
while eating. In others, the lower limbs feel heavy or 
numb, requiring an effort to raise them in walking; at 
other times pricking or darting pains in the calf of the 
leg, in the heel, or toe. 

Many men begin with pains in their back, which ex- 
tend over their hips, down to the calves of the legs. The 
latter is a very common symptom, owing to the close 
relation of the sciatic plexus to the prostatic plexus and 
associate ganglia. 



281 

Melancholia is a very common sequel of prostatic dis- 
ease : and it ( as do other neuroses resulting from dis- 
ease of the gland) assumes a periodicity at first; subse- 
quently it may become continuous. I have clincally ob- 
served in men suffering from prostatic neuroses that the 
periodicity is markedly analogous to the menstrual epoch 
of women, in that it first appears in paroxysms of about 
four-week intervals, and, as the disease becomes more 
aggravated, it assumes a periodicity of two weeks ; when, 
as the gravity of the disease becomes serious, it is daily 
or continuous. I would advise, in these obscure nervous 
diseases, or even in any chronic condition, where a 
monthly exacerbation appears, the examination of the 
prostate, or other pelvic organ. In some cases the 
periodicity is manifested by bouts of drinking. 

It may seem absurd to some ; and, if on examining the 
gland it is found to be healthy, there is no harm done ; 
when you can then dismiss it as being the most probable 
etiological factor. 

Clincal observation has demonstrated that young men 
suffering from prostatitis of the sub-acute form, are more 
subject to paraparesis; while middle-aged and old men 
affected with congested enlargement of the gland are 
more subject to hemiparesis. While this is not an in- 
variable rule, yet in the very large majority of cases, 
if the prostate be examined in these paralytic diseases, 
it will be found to be diseased. Insomnia, melancholia, 
and mania may follow either form of the disease ; but 
it is rare in the beginning of senile hypertrophy, or 
until acute paroxysms supervene. 

The innumerable nervous symptoms that result from 
reflex irritation of the prostate or adjacent organs are 
brought about much more frequently by the sympathetic 
system or vaso-motor nerves than by those of the cere- 



282 

bro-spinal system. Yet these are usually practically 
ignored as etilogical factors. The more highly devel- 
oped the nervous system of the individual, the wider is 
the effect produced by the shock of any disease of the 
gland. But in the spreading of the effect, the intensity 
at any given point is diminished. This furnishes the 
explanation of the seeming paradox that strong constitu- 
tions are more liable to severe local disease than are 
neurasthenics. The molecular changes produced by dis- 
eases meet far less resistance in highly involved organi- 
zations which are good conductors of every kind of 
motion, while the resistance offered by a strong constitu- 
tion tends to produce local functional disease. Thus it is 
that functional excesses in the strong tend to produce 
in them excessive functional nervous diseases. 

The same fact serves to explain another apparent 
paradox, that nervous hysterical patients, who run the 
gamut of nervous disorders every day of their lives, 
are frequently long lived; disease, as it were, proving 
an antidote to disease. The destructive force of disease 
which meets with vigorous resistance in a strong body, 
concentrates itself locally with lethal violence, while 
in the weak, nervous constitution, it is conducted away, 
attenuated, and rendered comparatively innocuous. 

MELANCHOLIC MANIA. 

This is one of the most distressing as well as most 
varied in its manifestations of any of the neurotic dis- 
eases, caused by prostatitis, or by any of the other 
pelvic organs. Among the incidents of most every phy- 
sician, long in practice, the proverbial phrase that "It 
never rains but it pours" has been tangibly presented 
at some time of his professional career. It fell to my lot 
some years ago to have had quite a number of these 



283 

cases of melancholia following in close order to one 
another. 

Case 62. Chronic prostatitis and melancholic mania. 
Merchant; aged 44; very emaciated, though strong and 
an active business man. For two years he had suffered 
with occasional attacks of nervous depression; followed 
by hot, alternating with cold, flashes. These " spells, " 
as he termed them, had gradually grown more frequent 
and aggravated. At first they would occur every three 
months, then monthly, and finally every two weeks. 
His temperature would never rise more than one-half 
degree, even when he said he felt as though he was 
burning up. I inquired as to the condition of his kid- 
neys, bladder and sexual organs. He was very reticent 
regarding them and at first strenuously objected to an 
examination. Finally, upon submitting to an examina- 
tion, the prostate was found to be exceedingly sensitive 
and slightly swollen. It was so sensitive that he refused 
to have it treated. He continued to grow worse, until 
he was advised by his wife and friends to take a rest. 
He went to a country town and engaged rooms at a hotel. 
He had been there just about ten days when he had 
"one of his spells." His wife sent for a physician; 
who, after having examined the man, prescribed some 
innocuous remedy and left. After having taken one 
dose of the medicine, the man conceived the idea that 
his wife had connived with the doctor to poison him for 
the purpose of procuring his money. He violently op- 
posed taking another dose of the medicine, to avoid 
which (having been persuasively urged to do so), he 
leaped from his bed and ran out of his room in his night 
clothes down the stairs from the sixth floor to the office, 
screaming "murder." He maintained that the author, 
only, knew his constitution and was capable of prescrib- 



284 

ing for him. He had his wife wire rue to come and see 
him (some two hundred miles distant). Several tele- 
grams were sent daily for three days, when I finally 
decided to go. On my arrival at noon, and making 
myself known to the clerk at the hotel, he said that my 
patient was in the dining room, across from the office. 
I was cordially greeted by both man and wife, who re- 
quested me to order my dinner. Questions were imme- 
diately propounded by the man regarding incidents at 
home; evidently, as I understood, to avoid mention of 
his health. He was quite cheerful, apparently, and dis- 
cussed different subjects intelligently. The subject of 
his health was not mentioned until, on leaving the dining 
room, he requested me to go with him to the parlor, 
where he narrated the incidents before mentioned, in a 
very quiet and rational manner, explaining his reasons 
therefor. He stated that he had had "one of his spells, " 
and that the first dose of medicine was poison ; and that 
he had acted in that way to attract the attention of 
the police, that they might arrest and lock him up, until 
I could arrive to treat him. I remained with him sev- 
eral hours and left him in the best of spirits; he con- 
senting to remain there several weeks until he regained 
his health. On the following morning I heard that 
he had returned home and was violently insane. He 
was arrested by the police and incarcerated. He sent 
for an attorney, to whom he explained that he had been 
arrested and imprisoned for sinister purposes. He was 
released, as he was as rational, apparently, as any one. 
In a few days thereafter he again became violent and 
Avas placed in custody at his home. During these attacks 
he would suffer with continuous priapism both day and 
night. During the rational intervals he would be com- 
paratively free from the annoying erections. He was 



285 

carried to the asylum in this state, where he remained 
a few months and then died. 

Case 63. Insomnia, melancholia, prostatitis. Clerk; 
aged 38; married. Very large, and apparently in ro- 
bust health. I was called in consultation, when the at- 
tending physician gave the following history: The pa- 
tient had never had any venereal disease, but had been 
addicted to excessive venery in early youth; and, at 
times, later, until within the past two years. He had 
periods of excessive sexual desires. One sexual congress 
seemed to intensify the propensity for a second or third 
in rapid succession. This would last for three or four 
days, when he would lapse into a state of melancholy 
and insomnia. He had at first the attacks monthly, at- 
tended with only slight depression of spirits; but for 
six months prior hereto he often would be scarcely 
relieved of one attack before the recurrence of a second. 
He would not average more than five hours ' sleep during 
the twenty-four, and only then when under the influence 
of a narcotic. There were few symptoms indicating 
prostatic trouble. At times the urine was voided more 
frequently than normal, and contained an excessive 
quantity of phosphates and some uric acid. 

I advised an examination of the prostate; this was 
opposed by the patient and not encouraged by the at- 
tending physician. I did not hear from the patient 
again for six months, when I was again called to see 
him with his physician. He had grown steadily worse 
and, though taking from sixty to eighty grains of sul- 
phonal daily, he was sleeping not more than three hours 
during the twenty-four. He had developed a religious 
mania, and was singing and praying much of his time. 
He had now become totally impotent. I again insisted 
upon an examination of the genital organs, which re- 



286 

vealed both, chronic prostatitis and vesiculitis. Imme- 
diate improvement followed treatment of the gland and 
vesicles, and today he is a healthy, active business man. 

I could report several other similar cases with various 
complications that have come under my observation, 
where relief of the prostate and vesicles was followed by 
complete recovery from all other nervous symptoms. 

The perversion of the sexual organsi, as a cause of 
lunacy, gave rise to the advocacy and practice, in some of 
our asylums a few years ago, of castration for its relief. 

Melancholia, as a result of prostatitis, does not always 
develop insanity. I have noted its manifestations in the 
most varied phases of hysteria, mental and physical 
weakness, obstinate pessimism, and occasionally extreme 
optimism. 

One hysterical patient that I can recall would lie down 
upon the floor and roll over and cry for a time and then 
laugh. He was forty-four years old, married, had three 
children, and never had gonorrhea. His prostate was 
so tender that he fainted when it was gently touched. 
He recovered entirely from his nervous symptoms after 
the relief of the prostatic trouble. These cases all have 
an exceedingly sensitive urethra, even those that never 
had gonorrhea. 

Dyspepsia and constipation are common sequels of 
prostatitis; often, too, when there are no indications 
pointing to disease of the gland. I recall one case who 
had suffered with indigestion and flatulency for several 
years. During this time he had consulted many phy- 
sicians and had taken all the indigestion remedies ad- 
vised by both physicians and druggists. He was existing 
solely upon milk and some form of Battle Creek food. 
There was not an objective symptom pointing to any 
form of disease of the gland, and I hesitated very much 



287 

to suggest an examination of it. He readily submitted 
to an examination, to my surprise, when I found the 
gland slightly affected. I had him discontinue the use 
of medicines and eat sparingly for a few weeks. I 
treated the gland through the urethra and rectum on 
alternate days, and did not give him a single dose of 
medicine. He fully recovered and gained twenty pounds 
in weight within two months ; and has never had a symp- 
tom of his former trouble since, though he eats anything 
he wishes. 

Other cases of indigestion, with pronounced symptoms 
of disease of the gland, have been quite common. 

Sciatica or affections of some of the branches of the 
sciatic nerve are common sequels of prostatis. 

IMPOTENCE. 

The term impotence has been denned in different ways. 
It may exist in a modified degree, or may amount to 
total incapacity to consummate the sexual act. There 
may be only a deficiency of erectile power ; or desire and 
capacity may both be lacking. Again, erectile power 
may be normal at times, when free from erotic excite- 
ment; and the organ became flaccid and useless in the 
presence of a woman. Sometimes an erection takes place 
at the proper time, but it does not last sufficiently long 
for intromission, much to the disgust and chagrin of 
both. At other times premature ejaculation occurs even 
at times before intromission. Various mechanical con- 
trivances have been constructed to overcome the ineffi- 
ciency of erectile power. One of these was to tie the 
dorsal vein of the penis, which process has since been 
abandoned. Various other mechanical appliances were 
perfected to increase the congestion of the organ, and 
thereby endeavor to bring about an increased erectile 



288 

power. These, too, have been abandoned, as not only 
useless, but because they brought about serious organic 
lesion. 

The chief reasons for the foregoing conditions are due 
to the fact that inflammation, granulated ulceration, and 
thickening of the mucous lining of the prostatic urethra 
(as shown by the red in Figure XIV) cause the loss of 
its normal elasticity. Erection is attended by normal 
congestion of the penis, prostate, and adjacent organs. 
This necessarily causes elongation of the penis. The 
urethra must, therefore, stretch to accommodate itself to 
this elongated condition. Normal elasticity exists 
throughout the urethra, with the exception of the con- 
gested portion in the prostatis urethra colored red in the 
illustration previously mentioned. This portion of the 
lining membrane, owing to the loss of its elasticity, fails 
to stretch in proportion to the other, and thereby pre- 
cipitates a premature discharge. The abnormal condi- 
tion of congestion prevents this part of the canal from 
accommodating itself to the elongated penis when erect. 

At other times this ulcerated portion of the prostatic 
urethra transmits an abnormal irritation to the prostatic 
ganglion, also causing a premature ejaculation. This 
irritation is repeated from time to time owing to the 
local inflammation of the prostate, and one ejection so 
arouses the irritation that there is a continuous repeti- 
tion unattended by the normal emotions. When such 
is the case, these premature discharges continue until 
they finally bring about total impotency, or complete loss 
of erectile power, as well as of all desire or even the 
normal pleasurable sensation attending the act. When 
such conditions are brought about by this frequent repe- 
tition of the irritation, mental depression, melancholy, 
and often insanity are the most natural sequelae. In 



289 

fact, most of the inmates of our lunatic asylums are 
brought there by lesions of this organ and their sequelae ; 
and the recognition of this fact led Dr. White about 
twenty years ago to advocate castration for the relief of 
insanity. 

I shall not here attempt a discussion of the normal 
mechanism of erection; it is chiefly under the influence 
of the nervous system, which is controlled mainly 
through the "sexual brain," located in the prostate, or, 
as many think, in the caput gallinaginis. There is no 
paralysis or loss of power in the muscular or vascular 
conditions of the organ that affect the mechanical part of 
the erection, as the parts mainly at fault are the pros- 
tatic ganglion and the genito-spinal center of the cord. 

Failure to perform the act, at some particular time, 
often becomes so impressed upon the mind of the man, 
that even after the restoration of the prostate to its 
normal condition, it requires several efforts to restore 
confidence. 

I recall the case of a libertine, who, suffering from 
prostatitis, had made repeated failures with his mistress, 
and after having been restored, would still fail with her ; 
yet complete the act perfectly with other women. 

There is often diminished sensibility of the penis and 
scrotum, which appear also cold and lifeless. 

Impotency due to disease of the prostate and vesicles 
is almost invariably attended with seminal loss in some 
form ; that is, in young or middle aged men. The terms 
in general use for unnatural seminal discharges are some- 
what confusing, as they are often used synonymously. 
Those to which I adhere are nocturnal or involuntary 
seminal discharges, pollutions and spermatorrhea. 

Nocturnal emissions often occur under normal condi- 
tions, when a man is single, young, strong, and virile, 



290 

and whose seminal vesicles are filled, and who has been 
abstemious with regard to sexual relations. Under these 
conditions the impulse is transmitted to the prostatic 
ganglion during sleep, and so rouses the organs by local 
irritation that an emission and orgasm are caused, and 
the man is aroused from sleep. 

Pollutions, on the contrary, may take place under 
similar circumstances; but they result when there is 
either disease of the prostate, or of the prostatic urethra, 
and the impulse has so aroused the prostatic ganglion 
as to have brought about such frequent discharges that 
loss of normal function has resulted, and the discharge 
occurs unattended with any emotion or sexual orgasm. 
These pollutions, however, occur rather in a passive 
form, while normal emissions that occur are attended 
with excitation. 

Spermatorrhea takes place in a slow, dribbing manner, 
without erection or orgasm. It produces a sensation as 
though something was running from the penis. This 
sensation may be concomitant with either of the previ- 
ously mentioned forms. Moreover, it is often the case 
that when prostatorrhea alone exists it is mistaken for 
spermatorrhea. The discharge in the latter disease is 
nothing more nor less than a catarrhal discharge of the 
prostate, resulting from chronic inflammation. Its pres- 
ence is often erroneously diagnosed as indicative of 
gonorrhea or gleet. I have known many young men to 
be treated for an indefinite period for gonorrhea, who 
had a simple prostatorrhea, resulting from masturbation 
and irritation of the gland. 

Nervous depression (or moodiness) is not due to the 
loss of semen but is due to a catarrhal discharge from 
the prostate and from lesions of this and adjacent organs. 
Even when seminal discharges are prominent, it is not 



291 

ascribable to this latter cause, but to the incessant reflex 
nervous irritation to the cerebro spinal center resulting 
from the condition of the diseased gland. 

Should an emission occur when asleep and not oftener 
than once in ten days or two weeks, in a man of vigorous 
habits, it should not be considered pathological, when 
the man had abstained from all sexual relations during 
that time. Ultzman and S. W. Gross concur in this view. 

I cannot impress too forcibly the importance of an 
examination of the gland in these obscure cases, as I 
know too well that many physicians are prone to neglect 
such, and yield too readily to an objection upon the 
part of the patient to submit to an examination because 
of over prudery, or "it suggests venereal disease. ' ' 

I can recall several suicides of prominent business 
men, who, if their prostatic conditions, had been properly 
diagnosed and relieved, could have been saved from an 
untimely death. 

Men suffering from melancholia, as a result of pros- 
tatitis, are much more able to resist the evil effects of 
the disease when employed than when idle. It is very 
unwise to advise such men to go away for a rest. I 
have known of several instances where men were so 
advised, and who, having no other mental employment 
than to brood over their ailments, became maniacal or 
suicidal. 

The simple knowledge of impotency so preys upon the 
minds of some men as to aggravate their physical and 
mental condition, impair their digestion, disturb their 
sleep, and wreck their health. 

STERILITY. 

Potentia coeundi does not always imply potentia gen- 
erandi. The latter depends entirely upon the procreative 



292 

power of the semen, while the former implies the ability 
of the man to complete the act of coitus. 

It is a well-known physiological fact that healthy pros- 
tatic fluid is essential to perpetuate the lives of the sper- 
matic germs until they reach their destination. The 
vesicles, too, are important factors towards maintaining 
the vitality of these germs. The prostate and vesicles 
are in such close proximity and so allied in their physi- 
ological relations, that disease of one readily extends to 
and involves the other. 

It is not infrequently the case that men are able to 
complete the act of coitus, yet the spermatozoa may be 
lifeless or so impaired in vitality from perverted prosi- 
tatic secretions as to be rendered sterile. The wives of 
such men are too often subjected to all kinds of treat- 
ment and operations for barrenness, when the fault lies 
with the men. Several cases of this kind have come 
under my care, where relief of the prostate was fol- 
lowed by fruitful results. 

PROSTATORRHEA. 

Ultzmann says: "With, every sexual excitement, as 
soon as erection of the penis has occurred, long before 
ejaculation of semen has taken place, a clear, transpar- 
ent, viscid drop, like white of egg, oozes from the meatus. 
This clear, viscid drop represents the secretion of the 
accessory glands of the urinary and genital tracts, and 
consists of the secretions of the prostate, of Cowper's 
glands and the glands of Littre. Since the prostate is 
the largest gland in this connection, it is evident that the 
mass of this fluid must be the prostatic secretion. If 
this clear, viscid fluid is secreted in greater amount, 
indeed continually, and without sexual excitement, this 
condition is called prostatorrhea. " 



293 

The definition or explanation of prostatorrhea, as given 
by Ultzmann is usually accepted by the profession, but 
it is far from being correct. Prostatorrhea is really an 
abnormal discharge from the prostate gland, resulting 
from inflammation and lesion therein. The normal secre- 
tion, as described by Ultzmann, is present in all men in 
health; and this secretion, under normal conditions, is 
requisite for the support and maintenance of the sperma- 
tozoids until they reach their destination. But when 
the secretion is the result of an abnormal pathological 
condition, then, instead of supporting the spermatozoids, 
it has a tendency to aid in their destruction. 

The fact is that the normal viscid secretion attending 
sexual excitement and erections, is often mistaken for a 
pathologic state, when it really indicates a healthy con- 
dition of the gland and is premonitory to a seminal ejec- 
tion. This prostatic secretion serves to lubricate the 
channels and favor the passage of semen, besides its aid 
in maintaining the lives of the spermatozoa. 

Prostatorrhea is due to an inflamed condition of the 
gland as a result of gonorrhea, masturbation or other 
sexual excitements. Prostatic calculi or rectal diseases 
may serve as exciting causes, but they are more fre- 
quently the effect, and not the cause of the trouble. 

The differential diagnosis between prostatorrhea and 
spermatorrhea depends largely upon microscopic and 
chemic examination of the secretion. The presence in 
the secretion of Bottcher's crystals and amyloid bodies 
would point strongly to prostatorrhea, while the pres- 
ence of spermatozoa would not exclude that condition as 
a possibility, as spermatorrhea often accompanies pros- 
tatorrhea, though the latter is much the more common. 

Azoospermia is a common sequel of prostatitis and 
vesiculitis, as the perverted secretions of these organs' 



294 

disorders tend to devitalize and destroy the spermatic 
germs and render the man sterile. 

The urine in these cases is variable in quantity, and 
is usually of light color, containing small shreds of 
hook-shaped flakes. 

Prostatic Faces. Just as Kelly describes an ovarian 
face in women, there is an analogous expression in most 
all men suffering from chronic prostatitis. It is quite 
noticeable in many men, and readily disappears upon 
restoring the gland to its normal condition. 

Glycosuria and albumen often appear in minute 
quantities where neurotic symptoms are prominent; but 
they are of transient nature and readily disappear as 
soon as the local trouble is relieved. Neither of these 
conditions implies interstitial nephritis. Claude Bernard 
demonstrated that puncturing the floor of the fourth 
ventricle would produce albuminuria or glycosuria, and 
it is now well known that many nervousi shocks cause 
these symptoms to temporarily appear. 

Imaginary Impotency. Much has been written and 
spoken of impotence existing only in the head. Many of 
these opinions have originated from some of the most 
prominent surgeons and genito-urinary specialists, who 
had either failed to locate the cause of the trouble or 
to relieve it after having discovered the source. But 
very few of these cases are really imaginary. 

Case 64. Aged thirty-two ; single. Never had gonor- 
rhea. He had been addicted to sexual abuses followed 
by frequent emissions and chronic discharge. The first 
physician treated him with tonics, or constitutionally; 
the second with sounds; the third with both. After 
having gone the rounds for six years, trying to get in 
shape to marry, he was advised to do so, and was told 
that he would then become normal. The trouble con- 



295 

tinned. Two years after his marriage he came to me for 
treatment. I discovered an inflamed prostate and 
urethra. Normal functions returned just as soon as 
these organs were relieved, without taking a dose of con- 
stitutional medicine. 

Case 65. Aged twenty-eight; strong and robust in 
appearance. He was not sure whether he had ever had 
gonorrhea or not, as some physicians had told him he 
had, and others that he had not. He was annoyed with 
excessive pollutions. Different physicians advised him to 
marry, and that his trouble was in his head alone. He 
recovered his sexual powers when relief of his prostate 
was effected. 

PARAPARESIS. 

This condition calls especially for a thorough exami- 
nation of the prostate gland and adnexa. For the past 
fifteen years or so, since I have had my attention more 
especially directed to the prostate as an etiological factor 
of this trouble, I have not seen a single case of para- 
paresis or impaired function of the lower limbsi, where 
the gland was not involved, unless the disease was due 
to syphilis or lesion of the spine. This condition occurs 
more often in young men who have been subject to ex- 
cessive masturbation or sexual indulgence, which brings 
about lesion of the prostate gland. 

The onset of the trouble is usually manifested by a 
sensation of heaviness or weight about the lower limbs ; 
which, as the disease progresses, becomes so marked as to 
interfere in climbing stairs. There is rarely any pain in 
these cases at first; and should it supervene at all, it is 
usually manifested by a few darting pains in some of the 
branches of the sciatic nerve, in the region of the pop- 
liteal space, or calf of the leg. 



296 




... il-.A 

Figure XXIX. 



297 

The disease may be so slight as to be almost imper- 
ceptible. It is indicated by marked loss of power or 
impaired functions of the body from the hips down. 
It almost invariably results from lesion of some one of 
the pelvic organs, and more especially of the prostate 
gland. It is usually attended by marked pain in the 
lower spine, as shown by the lower mark in Figure 
XXIX. Special attention is called to this mark, as the 
seat of the pain is usually concomitant with a lesion of 
one of these organs ; and is quite distinct from the loca- 
tion of the pain arising from the kidneys from which 
organ many people think this particular pain originates. 
Kef erring to the above figure it will be seen that the kid- 
neys are located on the margin of the lower rib, much 
higher than where the pain is felt. 

At times paraparesis slowly develops into paraplegia, 
with all its accompanying symptoms or pains in the calf 
of the leg, heel, hip, etc. At other times it develops 
very suddenly; total paralysis with loss of the entire 
limbs may occur within a single night. Again, one side 
only, generally the left, may be affected. 

This condition is most frequently brought about by 
lesion of the prostate gland, which is transmitted to the 
prostatic ganglion, thence to the genito-spinal center, 
causing local congestion, effusion, or plastic exudation, 
hemorrhage, etc., at the latter point. This trouble 
readily yields to treatment in the large majority of in- 
stances if the cause is first relieved, and the reflex irri- 
tation removed — then absorption of this effusion or 
exudation immediately takes place and there is a gradual 
restoration of the parts to their normal condition. At 
other times, should relief not be obtained, then paralysis, 
or total loss of power from the hips down, ensues. Too 
much stress cannot be made upon the importance of this 



298 

trouble. It is quite common, and is generally considered 
incurable. In point of fact the large majority of such 
cases are curable. Special attention is directed to the 
matter preceding this illustrating the functions of the 
nervous system, together with the reflexes arising from 
the prostate as being the chief etiologic factors. 

The progress of the malady is usually of an insidious 
nature, and especially is* due to masturbation. If due to 
excessive sexual indulgence and accompanied with a bout 
of drinking, it is liable to occur suddenly. I have seen 
cases where sudden paraplegia resulted from bouts of 
drinking. In rare instances of this affection, the pains, 
as before described, have been the prominent premoni- 
tory symptoms. Others have described sensations as 
though something was creeping up their limbs. 

Case 66. I recall the case of a man, twenty-eight years 
of age, who had been suffering eighteen months with 
paresis. There was no pain in the limbs, but the im- 
paired function became mere perceptible from week to 
week until there was total loss of power. During this 
time the young man had been treated by several physi- 
cians, and some of whom diagnosed the case as loco- 
motor ataxia. Not one of them suspected the prostate 
as the cause of the trouble, or even examined it. When 
I first saw him he had no more use of his lower limbs 
than if they were made of rubber. I found him totally 
impotent, with a persistent prostatorrhea and occasion- 
ally nocturnal pollutions. 

I directed my treatment entirely to the prostate, and 
improvement began at once. In six weeks ' time he could 
stand upon his legs; and after six months he was back 
at work, and one could scarcely detect any defect in his 
gait. 

Hemiparesis. This disease is common among older 



299 

men suffering from enlarged gland and hypertrophic 
inflammation of the prostate. The conditions brought 
about in the spinal column are very similar to those of 
paraparesis in young men. The main points of differ- 
ence are that in young men the paraplegia and para- 
paresis are usually precipitated from acute conditions 
of the gland — while in old men hemiparesis results from 
chronic conditions of the prostate gland and their se- 
quelae. The conditions causing the first, cause the sec- 
ond also, in the main. The cases I have seen have re- 
ported that the first symptom they noticed was the drag- 
ging of one foot in walking, or tipping the pavement 
with the toe. By observation it will be noticed that the 
end of the sole of the shoe is worn off, especially on the 
left side. The dragging is often noticed by a companion 
before the person himself. 

Case 67. I recall one case who said the first time he 
had his attention called to any defect in his left foot 
was when his wife, walking upon the street with him, 
said: "Will, for goodness sake quit scraping your foot 
on the pavement." He had never noticed it before, and 
when his attention was called to the fact he went along 
for some distance without doing so again; but his mind 
being withdrawn from his walking, he was again re- 
minded of it by his wife. When dressing the next morn- 
ing he for the first time noticed that the sole of his left 
shoe was much worn out at the toe, while the other was 
not. From that time on he noticed a perceptible im- 
pairment of his left side. This was followed by loss of 
co-ordination in writing. 

This case applied to me for treatment eighteen years 
ago. I did not know as much about the cause of these 
troubles then as now ; so I treated his spine by electricity, 
massage and mechanical movements for several months, 



300 

which gave him temporary relief; but he grew gradu- 
ally worse from month to month. He finally mentioned 
certain symptoms implicating the sexual organs that led 
to an examination of the prostate, which revealed the 
seat of the trouble. Noticeable improvement followed 
the treatment of the gland within two weeks. Three 
months thereafter he was able to resume his work and 
left the city. . I did not see him again for nine months ; 
he was then so far well that his defect was almost im- 
perceptible. 

Case 68. Merchant; aged fifty-six; married. Up to 
his fifty-third year he had been quite active. About that 
time he began to notice that he would scrape his right 
foot upon the pavement when walking. He could pre- 
vent this scraping, at first, when his attention was di- 
rected to it; but immediately on withdrawing his mind 
from the sluggish foot, the scraping of the pavement 
would recur. He next noticed an impairment of his 
right hand when attempting to tie a bundle. He was 
unable to grasp a string sufficiently tight to tie a knot. 
This condition grew worse by degrees, until he could 
not use his knife while eating. The left leg was equally 
impaired. Both hand and leg began to improve after 
the second week's treatment of a congested enlarged 
prostate. The gain was steady for two months; but 
there was still an impaired function. 



CHAPTER X. 

BRIEF OUTLINE OF THE ANATOMY, HISTOLOGY AND PATHO- 
LOGIC CHANGES AS INFLUENCED BY PERVERTED CONDI- 
TIONS OF THE PROSTATE GLAND, AND SEQUELAE TO 
VARIOUS LESIONS DETAILED IN THIS WORK. 

Urethra. The urethra being the channel through 
which the urine, the semen, and prostatic secretions all 
pass, and moreover, being the passageway for all the 
irritating discharges resulting from the existence of 
pathological conditions in the deep seated organs, rarely 
escapes becoming involved either as a sequel to disease 
of these organs, or from being so exposed. 

It is commonly regarded as the organ chiefly involved 
in lesion. It is the channel through which the deep 
seated organs are generally reached for purposes of 
treatment; and it often surfers maltreatment, both from 
the instrument used and (often) from the remedies ap- 
plied. Either of these causes an irritative inflammation, 
granulated urethritis, or sometimes stricture. But 
granulated urethritis (often supervening upon maltreat- 
ment and causing thickening of the mucous lining and 
thereby encroaching upon the calibre) is often mistaken 
for stricture; and is not seldom so treated as to bring 
about the very condition the operator is endeavoring to 
avoid. The urethra is extremely sensitive from meatus 
to bladder, more particularly so in the prostatic portion 
at the exit of the prostatic and ejaculatory ducts. This 
point (the verumontanum) is so sensitive that spasm 
often ensues from instrumentation, and this is often 
mistaken for stricture. 

301 



302 




Figure XXX (From a specimen in the Mutter Museum 
of the College of Physicians of Philadelphia). 



303 

Seminal Vesicles. The seminal vesicles and prostate, 
owning to their contiguous relations and allied functions 
and to the fact that the' latter is tunneled by t,he ducts 
of the former, are in close pathologic relation. As the 
swollen prostate must inevitably encroach by pressure 
upon the ejaculatory ducts, limiting thereby their elas- 
ticity and diminishing their caliber, increased exertion is 
required to expel the semen through the narrow chan- 
nels; and, should these latter organs be inflamed or 
tender, pain would follow the ejection of semen during, 
or immediately after sexual intercourse. The pain is 
usually felt in the region of the perineum, lower part 
of the rectum, in the back or along the course of the 
vas deferens in one or both sides of the groin. 

The pain resulting from the inflamed vesicles and 
ejaculatory ducts is of special significance in a diagnostic 
point of view, with reference to both the seminal vesicles 
and the prostate. 

Bladder. Owing to continuity in the structure of the 
parts involved, chronic inflammation of the prostatic 
urethra, if not properly attended to, will sooner or later 
extend to the prostatic and ejaculatory ducts and then 
into the bladder. In cases of long standing the bladder 
becomes inflamed in direct proportion to the length of 
time the condition has existed and to the degree of in- 
flammation. Figure XIII illustrates the beginning of 
the extension of the inflammation from the prostatic 
urethra and vesical neck. Figure XIV shows its exten- 
sion into the bladder, also the enlargement and swell- 
ing of the gland, and its encroachment upon the rectum, 
causing an ulcer there. The bladder is peculiarly sus- 
ceptible to become involved as a sequel to disease of the 
prostate. 

The walls of the bladder may also become corrugated 



304 




Figure XXXI (From a specimen in the Mutter Mnseum 
of the College of Physicians of Philadelphia). 



305 

and thickened; the size and capacity of the bladder are 
thus diminished, as is shown in Figures XXX, XXXI. 
These illustrations show true indurated hypertrophy and 
sacculated conditions of the bladder walls, induced by 
over-distension of the organ from an excessive quantity 
of urine and the efforts made to expel it. Certain mus- 
cles being constantly on the stretch become over-exerted 
and partially paralyzed, so as to lose the power of fulfill- 
ing their functions ; and thus the sacculation arises. The 
thickened walls become largely reduced after the inflam- 
matory condition of the prostate has been removed. 

Figure XXXII illustrates an extremely common con- 
dition of the bladder walls, the prostate, ureters, and pel- 
vis of the kidney. This condition follows all forms of 
diseases of the prostate — it is one of the most common 
and prominent sequelae of them. The inflammatory 
condition caused by disease of the prostate extends into 
the bladder, and by direct continuity from the bladder 
up the ureters to the expanded portion of the pelvis 
of the kidneys, as shown by their ragged, dilated and 
broken down appearance. The inflammation extending 
{from the bladder to the pelvis of the kidney is often 
met with. If the case be dealt with in time, and the 
prostate relieved, the true parenchyma of the kidney 
rarely becomes involved; but if neglected the inflamma- 
tion spreads from the pelvis to the parenchyma and pro- 
duces Bright 's disease. It is due to such condition of 
the pelvis of the kidney as are above illustrated, that 
we have the abundant whitish mass that periodically 
passes into the bladder and is evacuated, as described in 
a former chapter. 

Kidney and Ureters. Idiopathic disease of the kidney 
is very rare, although the great majority of physicians 
regard disease of the kidney as one of the most frequent 



306 




Figure XXXTI (From a specimen in the Museum of 
the Pennsylvania Hospital). 



307 

causes of mortality. Pain in the lumbar region of the 
spine, at or about the fourth or fifth vertebra, especially 
if the urine be turbid, leads a physician to at once sus- 
pect disease of the kidney. The pain usually felt in 
the small of the back is located much below the kidney, 
at the point of the genito-spinal center. (Figure 
XXIX.) This latter is close to the origin of the sciatic 
nerve. 

In passing, I may remark that sigmoiditis is often 
accompanied by a pain in the back of the neck — at the 
seventh cervical vertebra (Figure XXIX). 

Figure XXXIII illustrates the interior of the kidney. 
" U, ' ' the ureter passing from the kidney to the bladder 
(as seen in Figure XII) ; "P, " showing the pelvis, or 
an expanded portion of the upper ureter, and has prac- 
tically nothing to do with the true parenchyma of the 
kidney itself (2, 3, 4, etc.), which are the true secreting 
parts of the kidney. Inflammation often extends from 
the bladder up to the ureter, "U, " and involves "P, " 
the pelvis, which fill with a whitish muco-purulent se- 
cretion. The inflammation extending from the inflamed 
bladder up the ureters involves the pelvis of the kid- 
ney as illustrated in Figure XXXII. This is a very 
common condition, and often results in interstitial 
nephritis or " Bright 's disease.'' But the inflammation 
of the pelvis of the kidney and of the ureters can be 
relieved, and the lives of many men saved by pre- 
venting the extension of this inflammation to the paren- 
chyma of the kidney. 

During the many years I have treated these troubles, 
including many thousand cases, I have found only two 
of interstitial nephritis, or true parenchymatous in- 
flammation of the kidney. There were many cases of 
pyelitis, where the pelvis of the kidney had been in- 




Figure XXXIII. 



volved for many years without giving rise to the latter 
condition. " Bright 's disease" is an elastic term. 
Formerly, whenever albumen was found in the urine, the 
case was considered to be of this nature. Subsequently 
it was ascertained that only when the kidney was 
diseased was albumen found in urine ; the term was 
then made to include any disease of the kidney charac- 
terized by the presence of albumen. At the present day 



309 

the accepted terminology of ' ' Bright 's disease ' ' is that it 
includes any disease of the kidney. The term interstitial 
nephritis or Bright 's disease should be limited to paren- 
chymatous inflammation of the kidney. This definition, 
if strictly adhered to, would exclude pyelitis (inflamma- 
tion of the pelvis of the kidney) ; but the pelvis being 
part of the kidney, for the sake of convenience, we may 
include pyelitis under the general term " Bright 's 
disease. ' ? 

As pyelitis of grave form or of long standing leads 
to parenchymatous inflammation or interstitial nephritis, 
it must be considered a serious and dangerous disease. 
It is a potent causative factor of interstitial nephritis; 
and it is serious and dangerous within itself, causing 
the accumulation of matter that is extremely irritating 
to the genito-urinary passages. It also often initiates 
the formation of calculi within the pelvis of the kidney, 
and this is the precursor of stone in the bladder. 

A grave mistake is often made when physicians en- 
deavor to catheterize the ureters. The lumen of the 
ureter is ordinarily about the size of a common goose 
quill, and extends down behind the bladder, becoming 
somewhat constricted before it penetrates the bladder 
walls in an oblique direction beneath the mucous mem- 
brane, which latter serves somewhat as a valve. 

These two peculiarities serve to prevent the regurgi- 
tation of the urine back into the ureters and also render 
catheterization of the ureters extremely difficult. Any 
attempt made to force an instrument through this small 
constructed orifice only serves to irritate the already 
inflamed ureter, thereby provoking additional trouble 
not only in the ureter itself, but it is apt to cause exten- 
sion of the inflammation to the pelvis of the kidney as 
well as to the true kidney itself. This procedure, when 



310 

it is successfully accomplished, can only serve to carry 
infection to the pelvis of the kidney ; and when it is not 
successful it inflames the ureters at their orifices or in 
the ureters themselves. Without this intervention, these 
organs might remain free from serious lesion for many 
years. The writer has seen pyelitis follow attempted 
catheterization of the ureter, and in several instances 
these cases ultimately resulted in interstitial nephritis. 

Pyelitis, whether provoked by interference by cathe- 
terization of the ureter, or arising from any other cause, 
is a most common source of interstitial nephritis. Fill- 
ing of the pelvis of the kidney with any irritative secre- 
tion, arising from any cause, more frequently provokes 
(by reason of continuity of structure) true parenchymal 
inflammation of the kidney than any other cause. This 
is a very important point from a pathologic point of 
view, as the disease in question is one of the most fatal 
with which the human race suffers. 

Some twelve years ago I attended a case, of fifteen 
years' standing, suffering with stricture, prostatitis, cys- 
titis and nephritis. The trouble extended to the pelvis 
of the left kidney, and subsequently to the entire organ. 
Suppuration ensued, which was followed by an abscess 
on the back, over the left kidney. The abscess had 
formed, and had been evacuated three times during the 
preceding two years, before I saw the patient. He had 
suffered constant pain in that kidney, and was in very 
bad health. The abscess re-formed, and was evacuated 
only once during the early stage of my treatment. He 
afterwards became strong and healthy, and lived eight 
years. I never saw him during his last illness. His 
death was reported as due to nephritis, though no 
autopsy was made. 

Rectum. The rectum is the passage through which we 



311 

treat both the seminal vesicles and itself; and it, like 
the urethra, often becomes disturbed both by lesion and 
in function. Lesions are occasionally manifested in the 
rectum that doubtless arise from some pathogenic source 
in the prostatic vesicles or bladder. They can only be 
accurately detected by thorough exploration with a per- 
fectly electric-lighted speculum, so arranged as to reflect 
the light directly upon the parts being examined, as 
some of these lesions are so minute as to escape detection 
unless the passage is very thoroughly lighted — so very 
dark and obscure are these cavities. 

With the exception of the neck of the bladder and 
seminal vesicles, the rectum is the organ most frequently 
involved as a result of chronic prostatitis. The part 
most often affected is the front surface immediately 
opposite the prostate. Inflammation of this organ, 
owing to its close proximity to the rectum, readily ex- 
tends to the latter. Figure XIY shows the position 
where it most often occurs. If the inflammation is of 
short duration and the gland is only slightly affected, 
the rectum at this point will show a condition of red- 
ness, with only a limited protrusion of the prostate into 
the rectum and without abrasion of the surface of the 
mucous membrane. In cases of long standing prostatitis, 
where there is considerable protrusion of the gland into 
the rectum, there is, as an almost invariable result, lesion 
of the mucous surface, and this being constantly irritated 
by the passage of fecal matter, in turn reacts upon the 
prostate, serving to increase the irritation and inflam- 
mation of the latter. 



312 




Figure XXXIV. 

Engorgement of Portal Veins and Pampiniform Plexus. 
(Semi-diagramatic.) 

A. Appendix Vermiformis. B. Urinary Bladder. C. Colon — Ascending. C r . Colon 

— Descending. I. Small Intestine. L. Liver and Gall Bladder 

P. Pancreas. R. Rectum. S. Stomach. T. Testicle. 



CHAPTER XL 

CONGESTED ^FLAMED CONDITIONS ARISING AS SEQUELAE TO 
LESIONS OF THE PROSTATE, BLADDER, ETC., PREVIOUSLY 

DESCRIBED. 

Figure XXXIV gives a semi-diagrammatic illustra- 
tion of the congested and inflamed pelvic, abdominal, 
and thoracic viscera — the result of the lesions heretofore 
detailed. 

The pampiniform plexus of veins, including the 
spermatic vein, and those of the bladder and the pros- 
tate, under abnormal conditions become highly con- 
gested. The spermatic vein, running from the appen- 
dix (A) to B and throughout the epididymus and testi- 
cles (T) also becomes extremely congested, and often 
feels like a bag of worms under one's fingers. The 
existence of these enlarged veins has been a source of 
great profit to quacks, by their attributing so many 
troubles from which young men suffer, to these alone. 
As a matter of fact they give rise to little or practically 
no trouble; and the operations which young men are 
frequently induced to undergo do infinitely more harm 
than good. It is extremely difficult to separate these 
engorged veins from the artery, the spermatic cord, or 
the nerve ; and when one of these latter is tied ( during 
an operation) with the vein it often causes atrophy or 
total degeneration of the testicles, impairing to a serious 
extent the sexual power, and often giving rise to a local 
irritation which is irreparable. 

Removal of the lesion which causes the local congested 

313 



314 

inflammations of the prostate, of the seminal vesicles 
or other pelvic organs, gives relief to the congestion of 
these organs; and also to the congested condition of the 
spermatic cord, to which latter so many diseases and 
complications are erroneously ascribed by quacks and 
others for their own gain. 

The enlarged veins never return to their normal con- 
dition; but they can be so much reduced that no one 
could detect an abnormal condition ; and no harm results 
from the enlargement primarily. 

Similar conditions follow enlargement of both the 
portal and hepatic veins, as illustrated, and cause the 
same disturbed state of the entire ailmentary canal, in- 
cluding the colon, small intestines, pancreas, liver, and 
stomach. The lower border of the liver (L) is raised, 
in order to show the engorged, turgescent state of the 
gall bladder, and also that of the stomach, pancreas, and 
the kidneys (which are not shown in this diagram, yet 
equally involved), as are also the lungs and heart. 

In addition to the involvement of these veins the 
sympathetic and cerebro-spinal plexuses of nerves are 
equally disturbed. In fact it is through the vaso-motor 
system of nerves that this congested clogging up princi- 
pally occurs. 

The disturbance of both the kidney and the liver, 
resulting primarily from these lesions, and secondarily 
from the engorgement of the veins and the disturbed 
condition of the nerves, causes a perverted action of 
these organs. This perverted condition results in the 
production of uric acid. Any one may note the folly of 
continuing the administration of alkalies to neutralize 
excessive uric acid and increasing thereby conditions not 
only for the development of calculi but for the produc- 
tion of the various alkaline constituents that saturate 



315 

the blood vessels, thereby limiting metabolism, both by 
way of anabolism and catabolism. This is effected 
chiefly by reason of the clogging of the interstices of the 
capillaries, thus preventing nutritions matter from en- 
tering the various tissues in order to be assimilated, and 
likewise preventing the passing out of the excrementi- 
tious matter to be eliminated from the body. These 
alkaline substances, resulting as before explained from 
the efforts of physicians to neutralize the uric acid, not 
only retard metabolism, but also cause the saturation of 
all the tissues of the body, including the skin ; changing 
it from its normal soft elastic state to a dry, hard, and 
brittle one. 

Worse still, the heart and arteries suffer equally or 
more from this cause, resulting in sudden death from 
arterio-sclerosis. From this source (alkalies and alka- 
line mineral waters) comes the formation of emboli. 

Other lesions similar in character to these occur, and 
produce either disability or death by the formation of 
an embolus or thrombus from the debris denuded from 
the surface of an ulcer in e. g., the prostate, rectum or 
sigmoid flexure. Or it may even form from bacillus 
acting upon pus or other purulent matter and become 
drafted into the circulation. These conditions, together 
with the breakdown of the central nervous tissue result- 
ing from reflexes (described at length in a previous 
page) are the chief precursors of sudden deaths in more 
instances than almost any other cause. 

The coronary arteries of the heart, the basilar arteries 
of the brain, and the renal arteries of the kidneys are 
specially susceptible to emboli owing to their limited 
anastomosis, and their termination into minute arterioles 
and venules. Pus, bacteria, and particles of debris, enter 
the circulation through abrasions in the surface of the 



316 

prostate, vesicles, etc., and are carried along the arteries 
to one of these organs; and not being able to pass 
through the arterioles or venules to enter the return 
veins, they become obstructed and form a clot, or break 
down the thin delicate walls of these vessels. They also 
form abscesses, softening of the brain, degeneration, 
interstitial nephritis, and b\ r occluding the orifices of the 
heart sometimes cause early or sudden death. 




Figure XXXV. 

Figure XXXV illustrates the passage of such an embo- 
lus ("A" and "B") from left to right, showing its prog- 
ress along the blood vessels, until it reaches one too small 
for it to pass, and it becomes obstructed. This often 
takes place at the base of the brain, and in the fourth 
ventricle, causing either hemorrhage or effusion and 
sudden death, or gradual softening of the brain. The 
same pathological condition is equally liable to occur in 
the heart or kidneys. 



CHAPTER XII 

MISCELLANEOUS CASES. 

Case 69. J. K. L. ; male ; 9 years of age ; pale, deli- 
cate, headaches, wore glasses, had been circumcised in 
his infancy; no hereditary idiosyncrasy, father, mother 
and an older brother and younger sister in perfect 
health. He began at the age of 7 with slight headaches ; 
he was then supplied with glasses, some temporary re- 
lief — necessitated to discontinue school. He was very 
costive, and had been from youth. There was a draw- 
ing, creeping sensation across the lower abdomen, itch- 
ing about the anus, often requesting his mother to rub 
his perineum. He had been given considerable "worm 
medicines" from almost every physician that had been 
consulted previously, without results. At the age of 8 
he began having chorea, then petit-mal. At first these 
attacks recurred regularly each month, then weekly and 
finally two or three daily. The child had been dosed 
with bromides until he was weak, prostrated, dull and 
stupid, with appearance so white as if there was not a 
drop of red blood in his body. After much difficulty, 
one slight lesion was located in the rectum. Relief of 
this was attended with some benefit, but not as much as 
I had expected. Treatment for six months continued 
with but little relief, except that the epileptic attacks 
had grown less frequent. The bromides, of course, had 
been discontinued. I had begun to think that it was 
the cessation of the bromides that had kept up the epi- 
leptic attacks, but finally a more thorough physical ex- 

317 



318 

amination revealed a pyro-sac as the seat of the real 
trouble. Removal of this resulted in complete restoration 
of health. He has remained healthy ever since, and is 
now a strong, hearty boy of seventeen. 

Epilepsy. Case 70. Age 22, perfectly healthy to 
his seventeenth year. He then began having headaches 
and other nervous symptoms, until mild attacks of epi- 
lepsy supervened. His family physician administered 
to him first bromides and then opiates ; his spells con- 
tinued to grow in frequency and severity. He was ad- 
vised to see the writer when he was 22 years of age; 
he was then having sometimes two or three attacks daily. 
After each attack his doctor (?) would give him opiates 
to relieve the pain in his head, until he became addicted 
to them and could not do without them. After the cause 
of his trouble had been located and removed he con- 
tinued to have the attacks once a month, and later every 
two months, when I incidentally learned that he was 
taking morphia. I insisted on the young man's parents 
dismissing his physician, which they did, giving as a 
reason that the boy had been supplied with drugs. This 
physician had given the patient a prescription which 
included morphia and which had been refilled several 
times before I became aware of it. The spells by this 
time had entirely subsided, and he had not had one in 
four months. "When he was sent home, I notified his 
parents of the addiction of the young man, and insisted 
that they should keep him away from opiates; but sub- 
sequently learned that he had returned to them and 
that the attacks of epilepsy had recurred. 

Case 71. Man of thirty-three, single, lived an abstemi- 
ous and moral life; perfectly well until his thirty-first 
year. Then he began noticing tingling in his fingers, 
loss of memory, insomnia, acute indigestion, roaring 



319 

sounds in left ear, pain in calf of left leg and back of 
neck; gases in stomach, and bowelsi constipated. He 
was operated upon for appendicitis, then hemorrhoids. 
Grew worse. He was advised to undergo an operation 
on his liver for sand or gravel, as he had a continuation 
of the same pain in right side, after the operation 
for appendicitis. He consulted an oculist and aurist, 
who treated him for six months. No relief. He gradu- 
ally grew worse and was greatly emaciated, when he con- 
sulted the writer, upon the advice of his family physi- 
cian. Examination revealed an exceedingly tender and 
sensitive urethra, prostate and vesicles. Treatment for 
a short while relieved him somewhat, but at the expira- 
tion of six weeks he became discouraged and returned 
home. During all this time he had a continual, hacking, 
irritative cough. One of his physicians diagnosed his 
trouble as tuberculosis ; and advised him to go to Golden, 
Col. After three months he left there in a worse con- 
dition than he was in when he went. From there he 
went to Texas and Mexico, remaining there one year, 
and then returned home, expecting to die at any time. 
His family physician advised him to return to me as a 
last resort, stating that if I did not cure him he would 
never get well. Examination disclosed the prostatic 
urethra, bladder, and seminal vesicles exceedingly ten- 
der and hyperesthetic, but with no abrasion of the 
surface. 

I was convinced by this time that he was practicing 
masturbation, although he denied it strenuously, and 
claimed he was impotent. Treatment to allay local 
hyperesthesia improved his condition in every respect- 
even his appetite returning and his digestion improving. 
Finally he stated that his sexual desires were returning. 
He gained slowly from day to day; after six months 



320 

lie was restored to normal health, and is now engaged 
in his ordinary occupation. He has gained 19 pounds 
in weight, and occasionally writes to me to tell me that 
he is still improving in weight and strength. 



INDEX 



Abrasions of urethral mucosa ,12, 99 

Acetonemia, see blood. 

Activity of organs, results of too great 51 

Adnexa defined 63 

Age, in prostatic diseases 90, 164, 211 

Alkalinity, see blood. 

Albuminuria 294 

Alcohol forbidden 109, 167, 279 

A. M. A 20 

Amyloid bodies 293 

Anatomy of organs 301 

Appendicitis , 17, 74, 76, 77 

Aphrodisiacs 170 

Arterio-sclerosis 315 

Aspermatism 268 

Assimilation prevented 122 

Azoospermia 293 

B. 

Bacteria 72 

Back, pains in 280 

Bergmann, Dr 16 

Bernard, Claude 294 

Bichat, Dr 19 

Bicycle riding 107, 169 

Bladder 125, 171, 217, 221, 303 

Evacuation of 112, 214, 217 

Blood, abnormal conditions 48, 67, 151, 314 

Blockley Hospital, Philadelphia 278 

Bougie a boule Ill 

Bottini operation 192, 224, 226 

Breathing, difficulty of 71 

Bright's disease 18, 177, 240, 305 

Brown, Sequard 16 

Bottcher's crystals 293 

i 



ii INDEX. 

C. 

Capillaries, clogging of 315 

Capillary attraction 36 

Calcareous deposits 48 

"Catheter life," duration of 218 

Catheterization of ureters 240, 309 

In true hypertrophy 217 

Cautery applications 169 

Cancer 251 

Calculi 48, 145, 177, 180 

Calves of legs, pains in 59, 69, 70, 280 

Caput gallinaginis ■ 83 

Castration, practised in insanity 286, 289 

Catabolism 71 

Cellular development 31 

Cells, construction of the nerve 58 

Chicago Tribune 234 

Change of life, in men and women 12 

Concretions, prostatic 180 

Congestion of organs 51, 313 

Of blood vessels 92 

Conservation of energy 39 

Constipation 217, 286 

Consumption, Bergmann's cure 16 

Coccygeal ganglion 52 

Cough, irritative 69, 71 

Cold weather, effect on prostrate and bladder 106, 169 

Continence 107 

Curve, making the 10 

Cystoscope 113 

Its value in diagnosis 116 

D 

Depression, nervous 209 

Debris, resulting in infarctions 48 

Destructive transformations of tissues 155 

Diagnosis, erroneous 17, 77 

By Cystoscope 116 

Digital examination 173, 219 



INDEX. iii 

Differential diagnosis 167, 173, 213, 221, 236, 293 

Discharge, gleety 170 

Milky 140, 170 

Muco-purulent 171 

Prostate and vesicles, irritative to urethra 104 

Prostatic, mistaken for seminal 122 

Diabetes , 172 

Doctors and patients 21, 79, 277 

Drummers, medical men as 79 

Ducts blocked by infarctions 48 

Ejaculatory 83, 124, 269, 301 

Prostatic 83 

Dysuria „ 87, 109 

Diplococci 100 

Dyspepsia 286 

E. 

Elimination of waste products 71 

Electrolysis 43 

Electro therapeutics 43 

Electro magnetic equalizer 30 

Electro motor force, universal 26 

Electric potential 25 

And bodily conditions 26, 39 

Electricity, dangers of injudicious use 43, 127 

Valuable aid, properly used 42, 45 

Kinds of 25 

Emboli 48, 315 

Emotions, violent 85 

Emissions, premature 288 

Nocturnal 124 

Endocarditis 69 

Engorgement of veins, viscera, etc 313 

Energy, Conservation of 39 

Epilepsy 147, 317 

Erethism 108 

Erotic excitement 104 

Examination, objections to 277 

Experience, lack of 9, 125, 254 

Excesses, sexual 85, 168 

Eyes, involved 109 



iv INDEX. 

F 

Fades, prostatic 294 

Fears, morbid 147, 149 

Foods, prepared 74 

Folliculitis, catarrhal 123, 167 

Formalin , 75 

Forked stream ; Ill 

Friedmann, cure for consumption 16 

G. 

Ganglia, their importance 51 

Interrelation 52 

Functional disturbances 52 

Relation to organs 64 

Ganglionic brain 66 

Germs 72 

Genito-urinary diseases slighted 278 

Gleet 109, 170, 95 

Globus, major and minor 91 

Glycosuria 294 

Goat lymph injections 16 

Gonococci 95, 102, 275 

Gonorrhea, the great black plague 48 

Precursor of prostatitis 92 

Gonorrhea 92 

Incomplete cure 94 

Tenacious sequels 102 

Gout 152 

H. 

Hay fever 71 

Hemiparesis 298 

Heart involved 69 

Hemorrhoidal plexus 91 

Histology of the organs involved 301 

Hingston, Sir W 22 

Hips, pains in 280 

Horwitz, Dr. Orville 227 

Holmes, Dr. O. W 20 

Holmes, Dr. Bayard 21 



INDEX. v 

Horseback riding 107, 1G9 

Hypertrophy, true or senile, of the gland 211 

Hypochondriasis 278 

I. 

Impotence 287 

Imaginary 294 

Impulses, sensory 61 

Indigestion ■ 73, 286 

Infection 99 

Insomnia 71 

Instrumentation 10, 22, 88, 107, 1C9, 217, 301 

Instruments, crude 10 

Injection, for consumption, Bergmann 16 

Strong 169 

Iodine 16 

Insanity . . . . ■ 168 

"Is the practice of medicine a science?" 19 

Itching in perineum 56 

Interrelation of organs 64, 272 

Insidious nature of prostatic diseases 168 

J. 

Johnson, Dr 231 

Jones, Dr 234 

Jameson, Dr 19 

Jacobi, Dr. A 22 

K. 

Kidneys (see also pyelitis) 125, 305 

Kneipp, Father 28 

L. 

Lesions, special 10 

Prevalence 12 

And nervous diseases 13 

Precursors of degenerations, etc 48, 276 



vi INDEX. 

M. 

Marriage 274 

MacClagan, Dr 20 

Masturbation 105 

Meatus, glued up Ill 

Metastatic diseases 99, 124, 172 

Medical Times .' 227 

Medical reform 21 

Menopause 12 

Mental aberration 185 

Melancholic mania 184, 282 

Mental, undue taxation 85 

Milk 75 

Moodiness 290 

Morning drop 103, 111, 170 

N. 

Nausea 162 

Nerves of Prostate 85 

Newspaper medical advice 73, 234 

Nerve connections 56 

Neuroses of prostate and adnexa '. 276 

Neurasthenia. •••••• 166, 277 

Nephritis 177, 305 

Nervous systems, in intimate relation . 66 

Nocturnal emissions 121, 289 

O. 

Oils, injections for tuberculosis 16 

Operations, injudicious 22 

Not always forbidden 23 

Orchidectomy 225 

Orificial surgery 249 

Orchitis 89 

Orgasm, seat of 85 

Organs, vegetable and animal, analogy 34 

Congestion caused by overexertion 51 

Engorgement of - 313 

Functions 81 

Osteopathy 78 

Overticulae • • • • ^253 



INDEX. vii 



Paraparesis ' 295 

Paraplegia 295 

Paradoxes in nervous diseases 282 

Pathology of organs 301 

Pampiniform plexus .91, 313 

Perineum, dull aching pains 124, 137 

Itching in 56 

Phimosis 106 

Plants, nutrition of , 35 

Movement of . 37 

Polypoid tumors 170, 188 

Polyuria 172 

Pollutions 290 

Popliteal space 59 

Potential electric 25 

Preputial irritation 140 

Proud flesh 92, 170 

Prostatic calculi 180, 191 

Diseases, prevalence of 12, 47 

And venereal diseases 276, 277 

Prostate gland, analogous to uterus 166, 214 

Anatomy 81 

Function 85 

Examination necessary in obscure diseases 277 

Prostatitis, acute 87 

Sub-acute 90 

Chronic 90, 110 

Prostatitis, glandular 164 

Interstitial 124 

Prostatectomy 92, 223 

Prostatorrhea 170, 290, 292 

Proctoscope 120 

Prematureness . 122, 288 

Priapism 63, 108, 162, 271 

Pus sacs 154, 253 

Pyrosaks 154, 245 

Pyelitis ... 18, 176, 201, 240, 305 

Pyogenesis 171 



viii INDEX. 



It. 



Rectum 74, 86, 125, 169, 172, 245, 253, 310 

Report of cases treated 47 

Reflex actions 51, 62, 185, 218 

Rectal examination 173, 219 

Resection „ 249 

"Rheumatism" ' 69, 152 

Rigby, Dr. Jas 21 

S. 

Sacculation of walls of bladder 221, 303 

Salvarsan 16 

Sacral ganglion 52 

Sciatic nerve 58, 69, 172, 261 

Senility, premature 71 

Senile hypertrophy of the gland 211 

Seminal losses 289 

Vesicles 303, 125, 171 

Serous membranes 102 

Sexual indulgence, excessive 105, 168 

Appetite 85 

Neurasthenia 277 

Sigmoid-flexure 74, 245 

lesion of, and prostatic diseases 63 

Sigmoidoscope 120 

Sigmoiditis 245 

Sounds, use of. See instrumentation. 

Sour, Dr . . 15 

Spermatorrhea 290 

Sterility 291 

Stomach, disturbances in 218 

Stevens, Dr. A. H ''..'.. , 19 

Streptococci 102 

Stricture of Sigmoid flexure 247 

Of urethra Ill, 301 

Sulphuretted hydrogen injections 16 

Sympexia 183, 269 

Syphilitic prostatitis 268 

Sympathetic ganglia 51, 66, 280 

Synovitis. . .' 69, 102 

Stricture, organic, never found in prostatic urethra 123 



INDEX. i x 



Taylor, Dr 269 

Thompson, Sir Henry 180, 211 

Third lobe 213 

Thyng, Dr. D. K 243 

Thrombi 315 

Tissues, degeneration of 155 

Tobacco 279 

Toxic sources of disease and premature senility 71, 172 

Treatment 42, 125, 136 

Tuberculous prostatitis 268 

"Tuberculosis" 158, 258 

Tumors, polypoid 170 

Tenesmus 87 

U. 

Ultzmann 292 

Ulcerations in rectum 169, 247 

Urethra 110, 112, 301 

Elongation of, in hypertrophy 221, 236 

Urea 178 

Ureters 83, 305 

Catheterization 240, 309 

Uric acid (see also blood) 314 

Urinary fever 179 

Urine, abnormal 112, 171, 178 

Incontinence of 87 

Examination 175 

Residual 218 

Utricle 83, 111 

Urethritis, prostatic 94, 123 

Urination, painful 171 

Y. 

Varicocele 91 

Vaso-motor disturbance 48, 65, 281, 314 

Veins engorgement 312 



y 



x INDEX. 

Vegetables and animals, analogy 34 

Nutrition of 35 

Vegetative growths 92, 170 

Verumontanum 83, 219, 301 

Viscera, engorgement of 313 

Vesiculitis 110 

Vomiting * 162 

W. 

Waite, Dr 21 

Waste, elimination of bodily 71 



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IN PRESS 
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TREATMENT OF CHRONIC 
DISEASES 



A complete and concise exposition of the author's 
up-to-date methods in the treatment of Chronic 
Diseases of the Prostate, Heart, Lungs, Stomach, 
Kidneys, Rectum, Gleet, Neuroses, etc. etc. Fully 
illustrated description of the author's modes of 
procedure, the remedies used, and the technique 
of the instruments employed. 

A detailed description of the various lesions 
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